非发育不良口腔白斑的手术切除及随访。系统回顾

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2024-11-28 DOI:10.1016/j.ajoms.2024.11.009

Haruki Sato , Hideki Nakayama , Takahiro Yagyuu , Masanobu Abe , Taiki Suzuki , Daisuke Takeda , Masatoshi Adachi , Hidemichi Yuasa , Narikazu Uzawa , Hiroshi Kurita

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引用次数: 0

摘要

在这篇系统综述中，我们旨在澄清临床问题，“非发育不良的口腔白斑应该手术切除吗？”，按照日本口腔癌临床实践指南。方法我们检索MEDLINE、日本中央医学网和Cochrane中央对照试验注册库，以确定符合预先设定标准的文章。我们使用RevMan Web进行统计分析，并使用分级推荐评估、发展和评估方法评估证据的确定性。结果共纳入文献784篇，随机对照试验1项，纳入受试者235人。唯一可以评估的主要结局是恶性转化率，其风险比为1.14,95%可信区间为0.07-17.95。由于只有一项随机对照试验可用，因此未进行meta分析。由于缺乏资料，我们没有分析恶性转化的发生时间、复发率、临床缓解率和临床恶化率。证据的确定性很低。结论对于非发育不良口腔白斑患者，手术切除优于随访尚不能确定。未来的多中心数据收集，采用标准化和客观的措施，对于更好地确定非发育不良口腔白斑患者的手术切除指征至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Surgical excision and follow-up of nondysplastic oral leukoplakia. A systematic review

Objectives

In this systematic review, we aimed to clarify the clinical question, “Should nondysplastic oral leukoplakia be surgically excised?”, in accordance with the Japanese Oral Cancer Clinical Practice Guidelines.

Methods

We searched MEDLINE, Japana Centra Revuo Medicina Web, and the Cochrane Central Register of Controlled Trials to identify articles that met the pre-established criteria. We performed a statistical analysis using RevMan Web and assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

In total, 784 articles were identified, and one randomized controlled trial including 235 participants was selected. The only primary outcome that could be assessed was rate of malignant transformation, with a risk ratio of 1.14 and a 95 % confidence interval of 0.07–17.95. Meta-analysis was not performed because only one randomized controlled trial was available. The time to onset of malignant transformation, rate of recurrence, rate of clinical resolution, and rate of clinical deterioration were not analyzed due to the lack of data. The certainty of the evidence was very low.

Conclusions

We could not determine the superiority of surgical excision over follow-up in patients with non-dysplastic oral leukoplakia. Future multicenter data collection, utilizing standardized and objective measures, is essential to better define the indications for surgical excision in patients with non-dysplastic oral leukoplakia.

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