Oral medicine
Quality of life in patients with oral potentially malignant disorders: a systematic review

Some parts of this paper have been presented as a podium presentation at Gold Coast Health and Medical Research Conference in November 2013.
https://doi.org/10.1016/j.oooo.2015.01.025Get rights and content

There is a paucity of literature on quality of life (QoL) in patients with oral potentially malignant disorders (OPMDs) despite these conditions being relatively common, chronic, and potentially debilitating. The aim of this paper is to systematically review the literature on QoL in patients with OPMDs. A search from electronic databases PUBMED, MEDLINE, and CINAHL Plus retrieved 180 titles after removing duplicates, and a further 4 papers were identified by hand searching. Study of the abstracts identified 25 truly relevant articles, which were studied in full. Of these, 14 met our strict inclusion criteria. Most studies were cross-sectional; most were from Europe and have evaluated QoL in patients with oral lichen planus (OLP). The findings differ but, overall, do not provide evidence that patients with OPMDs have a poorer QoL compared with healthy patients. Several things may explain this apparently surprising conclusion. First, the quality of most articles was moderate or weak; second, most studies assessed QoL only in patients with OLP and cannot be generalized to all patients with OPMDs; last, direct comparisons between patients with OPMD and healthy controls were rarely included. The validity of the QoL instrument used for patients with OLP was frequently inadequate.

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Literature search

The present systematic review is registered with International Prospective Register of Systematic Reviews (Registration number: CRD42013006239). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.34 The databases searched for relevant articles included PUBMED, MEDLINE via OVID, and CINAHL Plus via EBSCO. Definite keywords that constitute OPMDs6 were used. Further, the keywords “oral precancerous lesion,” “oral precancerous condition,” “stomatological

Results

Figure 1 presents the information on publications screened, assessed for eligibility, and included in the review. The search from PUBMED retrieved 148 articles, whereas that in MEDLINE and CINAHL Plus via EBSCO databases yielded 79 and 30 titles, respectively. Thus, a total of 257 titles were obtained from the electronic search and 180 titles were left for screening after removing duplicates; additionally, 4 articles were retrieved by hand searching. The titles and abstracts of 184 articles

Discussion

Quality of life is gaining importance in public health research and practice and is being recognized more as a valid and important indicator of service need and intervention outcomes.50 The present systematic review evidences the paucity of literature on QoL in OPMDs compared with the abundant literature on QoL in patients with oral cancer. A general search in PUBMED using the terms “oral cancer” AND “quality of life” would yield more than 200 relevant articles.

The quality of the majority of

Conclusions

There is no strong evidence that patients with OPMDs have a poorer QoL compared with healthy patients. Several things may explain this superficially surprising conclusion. First, the quality of most of the articles included in this review was moderate or weak; second, most of the studies assessed QoL only in patients with OLP, and these cannot be generalized to all patients with OPMDs; finally, direct comparisons between patients with OPMDs and healthy controls were rarely included. The

References (62)

  • F. Gorouhi et al.

    Randomized trial of pimecrolimus cream versus triamcinolone acetonide paste in the treatment of oral lichen planus

    J Am Acad Dermatol

    (2007)
  • F. Kaliakatsou et al.

    Management of recalcitrant ulcerative oral lichen planus with topical tacrolimus

    J Am Acad Dermatol

    (2002)
  • C. McGrath et al.

    Patient-centred outcome measures for oral mucosal disease are sensitive to treatment

    Int J Oral Maxillofac Surg

    (2003)
  • A.M. Hegarty et al.

    Fluticasone propionate spray and betamethasone sodium phosphate mouthrinse: a randomized crossover study for the treatment of symptomatic oral lichen planus

    J Am Acad Dermatol

    (2002)
  • S. Kularatna et al.

    Health state valuation in low- and middle-income countries: a systematic review of the literature

    Value Health

    (2013)
  • J. O’Brien

    Head and neck: oral cavity and oropharyngeal tumors; salivary gland tumors

    SRPS

    (2004)
  • Y.P. Talmi

    Quality of life issues in cancer of the oral cavity

    J Laryngol Otol

    (2002)
  • E. Torres-Carranza et al.

    Assessment of quality of life in oral cancer

    Med Oral Patol Oral Cir Bucal

    (2008)
  • S. Warnakulasuriya et al.

    Nomenclature and classification of potentially malignant disorders of the oral mucosa

    J Oral Pathol Med

    (2007)
  • A. Villa et al.

    Oral cancer and oral erythroplakia: an update and implication for clinicians

    Aust Dent J

    (2011)
  • A.R. Kerr et al.

    A systematic review of medical interventions for oral submucous fibrosis and future research opportunities

    Oral Dis

    (2011)
  • P.B. Sugerman et al.

    Oral lichen planus: causes, diagnosis and management

    Aust Dent J

    (2002)
  • A.M. Ranginwala et al.

    Oral discoid lupus erythematosus: a study of twenty-one cases

    J Oral Maxillofac Pathol

    (2012)
  • J.C. Atkinson et al.

    Alter, Oral and dental phenotype of dyskeratosis congenita

    Oral Dis

    (2008)
  • S.S. Napier et al.

    Natural history of potentially malignant oral lesions and conditions: an overview of the literature

    J Oral Pathol Med

    (2008)
  • J.E. Bouquot

    Oral leukoplakia and erythroplakia: a review and update

    Pract Periodontics Aesthet Dent

    (1994)
  • D.V. Kleinman et al.

    Toward assessing trends in oral mucosal lesions: lessons learned from oral cancer

    Adv Dent Res

    (1993)
  • L.W. Smith et al.

    Oral cancer and precancerous lesions in 57,518 industrial workers of Gujarat, India

    Indian J Cancer

    (1975)
  • N.W. Johnson et al.

    Epidemiology and aetiology of head and neck cancers

  • B.E. McCartan et al.

    The reported prevalence of oral lichen planus: a review and critique

    J Oral Pathol Med

    (2008)
  • M.A. Sprangers et al.

    The European Organization for Research and Treatment of Cancer. Approach to quality of life assessment: guidelines for developing questionnaire modules. EORTC Study Group on Quality of Life

    Qual Life Res

    (1993)
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