Prospective evaluation of the incidence of oral cancer in a Caucasian population following a confirmed diagnosis of Oral Lichen Planus within 30 years

The most important complication of oral lichen planus (OLP) is the development of oral squamous cell carcinoma (OSCC), but this is still a controversial matter. The purpose of the study was to estimate in a Caucasian cohort of OLP patients the risk for OSCC and the factors related that can influence the prognosis. 3.173 patients with histologically confirmed OLP diagnosed from January 1988 to December 2018, were followed-up to the end of December 2020. During the follow-up period 82 of them had a malignant transformation (2.6%) counting 32 men and 50 women. Two analyses have been conducted, the first one on the OLP patients in order to investigate relations with age, gender, type of OLP, site of onset, smoking, HCV, and therapy. The second one on the patients with malignant transformation analyzing some additional factors, such as staging and grading of the carcinoma, frequency of the OLP check-ups, treatment, and survival rates. The higher age of the patients and the red type of OLP revealed significant results about the development of the cancer (HR 1.04 and 1.87, respectively). HCV infection is higher in OLP patients but without a statistically significant relation. Survival rate in patients who developed an OSCC at 5 years is around 82.0%, decreasing to 67.0% after 10 years.