{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:47:40Z","timestamp":1790347660710,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Oral leukoplakia (OL), oral lichen planus (OLP), and oral submucous fibrosis (OSF) are precancerous lesions known to progress to oral squamous cell carcinoma (OSCC). The transformation rates to OSCC are controversial and have been based on small, heterogeneous, single\u2010institution studies. We present the largest study to date looking at the malignant transformation rates of these oral premalignant disorders (OPMD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study within the TriNetX database. Patients aged \u2265\u200918 with a diagnosis of OL, OLP, and OSF between 2008 and 2018 were included, allowing for up to 5\u2009years of follow\u2010up. The primary outcome was the 5\u2010year rate of OSCC transformation compared to a control cohort. Secondary outcomes included treatment pathways and survival. Descriptive and comparative statistics were conducted using TriNetX software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Totally, 59,204 patients with diagnosed OL, OLP, or OSF were included. The average age of all included patients was 55.8\u2009\u00b1\u200914.1; the majority were female (<jats:italic>n<\/jats:italic>\u2009=\u200931,805, 53.7%) and white (<jats:italic>n<\/jats:italic>\u2009=\u200933,867, 57.2%). Rates of nicotine and alcohol dependence were 8.7% and 2.8%, respectively. The 5\u2010year malignant transformation rates of OL, OLP, and OSF were 15.6%, 1.4%, and 18.6% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01 compared to control), with an overall malignant transformation rate of 6.2% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01 compared to control). The 5\u2010year Kaplan\u2013Meier survival probability was 94.3%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results indicate the rates at which patients with OPMD (OL, OLP, and OSF) progress to OSCC are higher than previously reported. Transformation rates for OL and OSF in particular underscore the need for close monitoring and prompt treatment to avoid malignant transformation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Retrospective cohort study\u2014Level 3.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.32236","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T03:48:40Z","timestamp":1746848920000},"page":"3654-3659","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Malignant Transformation Rate of Oral Premalignant Disorders: A Large Database Analysis"],"prefix":"10.1002","volume":"135","author":[{"given":"Andrew","family":"Meci","sequence":"first","affiliation":[{"name":"The Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-1097","authenticated-orcid":false,"given":"Neerav","family":"Goyal","sequence":"additional","affiliation":[{"name":"The Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"},{"name":"Penn State Milton S. Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2822-4116","authenticated-orcid":false,"given":"David","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"The Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"},{"name":"Penn State Milton S. Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1102\/1470\u20107330.2005.0029"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998221098011"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2020.05.011"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jop.12726"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.14678"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2016.10.012"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2016.03.011"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2012.08.014"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26006"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/cci.17.00067"},{"key":"e_1_2_8_12_1","volume-title":"In Outcomes Analytics, What Software Does TriNetX Use to Generate Results?","author":"TriNetX","year":"2023"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2018.03.010"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2017.08.001"},{"key":"e_1_2_8_15_1","volume-title":"SEER Cancer Statistics Review, 1975\u20132018","author":"Howlader N.","year":"2021"},{"issue":"6","key":"e_1_2_8_16_1","first-page":"870","article-title":"Screening for and Diagnosis of Oral Premalignant Lesions and Oropharyngeal Squamous Cell Carcinoma: Role of Primary Care Physicians","volume":"54","author":"Epstein J. 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