Management of Surgical Margins in the Excision of Oral Leukoplakia: A Scoping Review

OBJECTIVE: To map the literature on management of surgical margins for oral leukoplakia (OL) and proliferative verrucous leukoplakia (PVL). METHODS: Searches were performed in five electronic databases and gray literature. Studies involving patients undergoing any type of surgical excision of OL or PVL were included. Data extraction focused on surgical technique, margin size, method of margin delineation, and recurrence outcome. Margin size was categorized in centimeters. RESULTS: Ninety-one studies were included. More than half of the studies (54.9%) did not report the width of surgical margins. Among those that did, margins between > 2 and < 3 mm were the most frequently reported (19.7%). Notably, 94.5% of the studies did not specify the criteria used to determine the margin width. Furthermore, 76.9% failed to describe the method used to delineate lesion margins. High recurrence was observed in 15.1% of OL cases with surgical margins ≤ 2 mm and in 40% of PVL cases with margins > 2 to ≤ 3 mm. Lesions with margins between 3 and 5 mm showed a lower recurrence rate. CONCLUSION: We identified a lack of standardization in the reporting of surgical margins. Excision with 5 mm of clinically healthy tissue should be considered the optimal approach for the surgical management.