Leukoplakia and Squamous Cell Carcinoma

The aim of this chapter is to give a comprehensive overview on the clinical manifestation and histopathologic features of the most frequent premalignant conditions of the oral mucosa and their sequela, squamous cell carcinoma and to provide a pragmatic guideline for their management. Oral premalignant disorders (OPMD) are a group of conditions that carry a risk of development of squamous cell carcinoma of the oral cavity. The overall prevalence of OPMD worldwide is about 4.5%, and males are more frequently affected than females. The prevalence differs also according to the ethnic groups and related nutritional habits. Asian and South American/Caribbean populations have higher prevalence rates than Europeans. Careful diagnosis and follow-up including histopathologic assessment plays a key role in the management and prevent clinical mistakes and the development of oral cancer. Severe epithelial dysplasia and carcinoma in situ of the oral mucosa are serious pathologies and have to be ablated or removed surgically. Upon diagnosis, treatment of invasive squamous cell carcinoma requires staging, including assessment of local invasion, loco-regional lymph nodes involvement and potential distant metastasis. Surgical therapy is recommended for curative treatment and reconstruction is essential to preserve oral function and restore facial aesthetic. In advanced stages, primary or adjuvant radiotherapy improve both disease-free and overall survival.