The use of CO2 laser in the treatment of oral white patches:: outcomes and factors affecting recurrence

Laser therapy has been a favoured treatment regime for oral leukoplakia since the mid 1980s. There is no information in the literature regarding factors affecting outcomes in patients with oral leukoplakia. Forty-three patients (mean age 60.3 +/- 13.6 years) with 73 primary oral leukoplakia were assessed for outcome and factors affecting survival. Dysplastic lesions were found in the majority of patients. The male to female ratio was 1.7:1 with 74% ex- or current smokers, 27% consuming alcohol and 31% continuing to smoke after treatment. The mean observation time was 47.2 +/- 28.2 months (range 2-102 months). Disease-free survival was 55.4% at 3 years that dropped to 33.9% after 5 years. The malignant transformation rate was 7.3%. No significant prognostic factors were found on univariate analysis but alcohol consumption (P = 0.034) and previous malignancy (P = 0.018) were found to be significant prognostic indicators using multivariate analysis. Continuation to smoke approached significance (P = 0.061). Similar disease-free survival and malignant transformation rates with minimal complications were found as compared to the literature. Recommendations for minimizing recurrence are presented. Long-term follow up and removal of aetiological factors, such as smoking and alcohol, are advised.