Oral Precancer: Diagnosis and Management of Potentially Malignant Disorders

Contents

List of Contributors 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