{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:33:35Z","timestamp":1791855215523,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To update the current evidence on the malignant transformation of oral leukoplakia (OL), including all studies published worldwide on the subject, selected with the maximum rigor regarding eligibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>MEDLINE, Embase, Web of Science and Scopus were searched for studies published before June\u20102024, with no lower date limit. The risk of bias was analyzed using the Joanna Briggs Institute tool for meta\u2010analyses of proportions. We carried out meta\u2010analyses, explored heterogeneity across subgroups and identified risk factors with potential prognostic value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010five studies (41,231 with OL) were included. The pooled malignant transformation proportion for OL was 6.64% (95% CI\u2009=\u20095.21\u20138.21). The malignant transformation did not significantly vary by time periods (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.75), 5.35% prior to 1978, 7.06% from 1979 to 2007 and 6.97% during more recent times. The risk factors that significantly had a higher impact on malignant transformation were the non\u2010homogeneous leukoplakias (RR\u2009=\u20094.23, 95% CI\u2009=\u20093.31\u20135.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), the larger size (RR\u2009=\u20092.08, 1.45\u20132.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), leukoplakia located on the lateral border of tongue (malignant transformation\u2009=\u200912.71%; RR\u2009=\u20092.09, 95% CI\u2009=\u20091.48\u20132.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), smoking (RR\u2009=\u20091.64, 95% CI\u2009=\u20091.25\u20132.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and the presence of epithelial dysplasia (RR\u2009=\u20092.75, 95% CI\u2009=\u20092.26\u20133.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OL presents a considerable malignant transformation probability that is especially increased in large non\u2010homogeneous lesions in smokers, located on the lateral border of the tongue, with epithelial dysplasia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.15140","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T03:53:39Z","timestamp":1727150019000},"page":"69-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":88,"title":["Malignant transformation of oral leukoplakia: Systematic review and comprehensive meta\u2010analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1649-3116","authenticated-orcid":false,"given":"Liliana Aparecida","family":"Pimenta\u2010Barros","sequence":"first","affiliation":[{"name":"Dental Sciences Graduate Program Federal University of Espirito Santo  Vitoria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6942-7772","authenticated-orcid":false,"given":"Pablo","family":"Ramos\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biosanitaria, School of Dentistry University of Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0791-6639","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Gonz\u00e1lez\u2010Moles","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biosanitaria, School of Dentistry University of Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7822-0968","authenticated-orcid":false,"given":"Jos\u00e9 Manuel","family":"Aguirre\u2010Urizar","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Medicine &amp; Pathology Unit, Department of Stomatology, Faculty of Medicine and Nursery University of the Basque Country\/EHU  Leioa Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2103-0746","authenticated-orcid":false,"given":"Saman","family":"Warnakulasuriya","sequence":"additional","affiliation":[{"name":"Faculty of Dental, Oral &amp; Craniofacial Sciences WHO Collaborating Centre for Oral Cancer, King's College London  London 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