Oral Squamous Cell Carcinomas Developing from Oral Lichen Planus: Do They Differ in Recurrence and Metastatic Potential?

Background: Due to the low proportion of squamous cell carcinomas of the oral cavity (OSCC) developing from oral lichen planus (OLP-OSCC) there is only little data regarding the frequency of lymph node metastasis and clinical characteristics such as relapse and outcome in this sub-entity. Therefore, a retrospective analysis of OLP- OSCC was performed. Methods: In a retrospective monocenter analysis, all consecutive patients with an OSCC treated in the time period 2000 to 2016 were composed. All patients with an OSCC developing from OLP/ OLLs were identified and analyzed for epidemiological data, risk profile, location of primary tumor, pTNM classification, lymph node metastasis, primary therapy, recurrence, and outcome. Results: A total of 103 patients (45%♂/ 55%♀) with an average age of 62 ± 14y were included in this study. At the time of initial diagnosis, 17% (n = 18) of patients had cervical metastases (CM) whereas only 11% (11 patients) displayed advanced tumor sizes (T > 2). T-status (p = 0.003) and histopathological grading (p = 0.001) had an impact on the incidence of CM. 39.6% of the patients developed a relapse after an average of 24 months with a mean of two recurrences per patient. Advanced tumor size had a significant impact on the 5-year overall survival and was associated with disease free survival of the patients (p < 0.001, respectively p = 0.004). Conclusion: Even if initial lymph node metastases were not found more frequent, more aggressive recurrence patterns compared to OSCC could be demonstrated for OLP-OSCC. Therefore, a modified recall for these patients might be necessary.