Recurrences following treatment of proliferative verrucous leukoplakia: A systematic review and meta-analysis.

Abstract

OBJECTIVE\nA systematic review and meta-analysis was made of the incidence of recurrences in patients with proliferative verrucous leukoplakia subjected to different types of treatment.\n\n\nMETHODS\nThe study was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. A literature search was made in the Medline (PubMed), EMBASE and Web of Science databases, together with a manual search, covering the period from 1985 to January 2020, with no language restrictions. Studies were included if they described treatments applied to at least 10 patients with the corresponding outcomes. Methodological quality was evaluated using Jadad scale and Newcastle-Ottawa tool. Global incidence was calculated by random effects meta-analysis using the Comprehensive Meta-analysis version 3.0 software. Publication bias was assessed using funnel plots and the Duval and Tweedie trim and fill method.\n\n\nRESULTS\nOf the 922 identified articles, 12 were found to meet the inclusion criteria. Most of them presented moderate or low risk of bias. A total of 397 patients were analyzed. The mean age was 62.34 years and 248 were women (62.5%). The mean follow-up was 79.3 months. The most frequent treatment was surgical removal with a cold scalpel or laser (339 patients). A total of 232 subjects presented lesion recurrence. The combination of proportions global effect meta-analysis yielded a recurrence rate of 67.2% (95%CI: 48.3-81.8), with the absence of publication bias.\n\n\nCONCLUSIONS\nThere is not enough scientific evidence to conclude that any treatment strategy is able to reduce the recurrence in proliferative verrucous leukoplakia.