Oral Precancer
Diagnosis and Management of Potentially Malignant Disorders

Without early detection, oral cancer is deadly. Protect your patients by applying the latest clinical interventions.

Rates of new oral cancer cases continue to increase and mortality rates remain alarmingly high. Oral
cancer may be preceded by clinically identifiable precancerous changes in the oral mucosa, which offer a therapeutic window of opportunity to intervene and halt disease progression to carcinoma development.

Written and edited by prominent researchers in the field, Oral Precancer:

• Reviews current scientific research on precancer conditions of the oral cavity providing evidence-based analysis of the nature and behavior of potentially malignant and deforming oral diseases
• Explains the principles of prevention, diagnosis and management of potentially malignant disorders of the oral cavity
• Details a practical and reliable interventional treatment strategy to facilitate early diagnosis and effective treatment of both precancer and early invasive carcinoma
• Contains a chapter devoted to illustrative case histories, high-quality, color, clinical photos, reference sections in each chapter listing relevant review articles, and more

From start to finish, Oral Precancer offers undergraduate students, clinicians, and professors an invaluable resource to minimise the morbidity and mortality of this most significant and life threatening of oral conditions.

Preface

Acknowledgements

1. Introduction

General Introduction

Epidemiology

Prevention Treatment Strategies

Terminology

Summary

References

2. Structure and Function of Oral Mucosa

Introduction

Applied Anatomy of the Oral Cavity

Function of the Oral Mucosa

The Microanatomy of Oral Mucosa

Regional Variation of Oral Mucosa

Oral Epithelial Cell Kinetics

Oral Epithelial Cell Proliferative Activity

Anatomical Site Predilection for Oral Carcinogenesis

Summary

References

3. Oral Carcinogenesis

Introduction

Oral Cancer and Precancer

The ‘Progression Model’ for Oral Cancer

Aetiology and Risk Factors

Patient and Risk Factor Profiling

Summary

References

4. Clinical Presentation of Oral Precancer

Introduction

Clinical Terminology

Precancerous (Premalignant) Lesions

Precancerous (Premalignant) Conditions

Multiple Lesion Disease

Summary

References

5. Diagnostic Methods

Introduction

Screening

Clinical Examination Techniques

Vital Tissue Staining

Light Based Detection Systems

Brush Biopsy and Exfoliative Cytology

Clinical Diagnosis in Practice

Summary

References

6. Pathological Aspects of Oral Precancer

Introduction

Biopsy Techniques

The Role of the Pathologist

Histopathological Features of Oral Potentially Malignant Disorders

Grading of Dysplasia

Limitations in Conventional Pathological Techniques

Summary

References

7. Management of Oral Precancer

Introduction

Risk Factor Modification

Observation versus Intervention

Medical Treatment

Surgical Treatment

Interventional Laser Surgery

Combined Treatment Modalities

Patient Follow Up and Surveillance

Summary

References

8. Clinical Outcome

Introduction

Clinical Outcome Studies

Patient Cohort Studies

Definitions of Clinical Outcome

Newcastle Patient Cohort Studies

Patient Follow Up

Prediction of Clinical Outcome

Summary

References

9. Malignant Transformation and Oral Cancer Development

Introduction

The Risk of Progression to Oral Carcinoma

Malignant Transformation versus Oral Cancer Development

Interventional Laser Surgery and Oral Cancer Prevention

The Newcastle 10 Year Follow Up Study

High and Low Risk Patients

Clinical Signs of Oral Squamous Cell Carcinoma

Diagnosis and Management of ‘Unexpected Malignancy’

Prognosis for the ‘Transformed Patient’

Summary

References

10. The Future

Introduction

Prevention of Oral Precancer

Early Diagnosis of Potentially Malignant Disease

Interventional Management Strategies in the Future

Individualised Patient Treatments – Biomarkers and Targeted Chemoprevention

Future Research Directions

Summary

References

11. Case Histories

Introduction

Diagnosis of Unexpected Malignancy

Multiple Lesion Disease Responding to Conservative Management

Multiple Lesion Disease Requiring Repeated Laser Treatments

Proliferative Verrucous Leukoplakia

Localised Oral Lichenoid Reaction

Multiple Oral Lichenoid Reactions

Widespread Dysplastic Oral Lichenoid Reactions

An Immunosuppressed Patient

Chronic Hyperplastic Candidosis

Tobacco Associated Hyperkeratosis

Malignant Transformation in Longstanding Non-erosive Lichen Planus

Summary

12. Conclusions

Oral Cancer Potentially Malignant Disorders

Clinical Management

Patient Care Pathways

Public Health Strategies

Future Directions

Index