Idrees M, Kujan O, Shearston K, Farah CS. Oral lichen planus has a very low malignant transformation rate: A systematic review and meta-analysis using strict diagnostic and inclusion criteria. J Oral Pathol Med 2020; DOI: 10.1111/jop.12996. [Epub ahead of print].

Reported OLP malignant transformation rates are exaggerated and do not reflect the actual clinical course of the disease according to strict clinical and histopathological criteria.

This systematic review and meta-analysis assessed the malignant potential rate of OLP and considered the influence of associated risk factors. All reports that documented MT of OLP and published in English until January 2020 were included if they met the following criteria: i) the presence of a properly verified OLP diagnosis; ii) a clear description of the cancerous lesion developing at the same site as the verified OLP lesion; and iii) a follow-up period of a minimum of 6 months prior to carcinoma development. Thirty-three studies were included with a total of 12,838 OLP patients. Of these, 151 cases were initially considered to have progressed to carcinoma (1.2%). However, after applying strict criteria, 56 cases were considered to have undergone MT from OLP (0.5%). The risk of MT was significantly higher among OLP patients who smoked, consumed alcohol, were seropositive for HCV, and/or displayed a red OLP subtype.