Development of A Novel Prediction Model for Assessing Malignant Transformation of Oral Epithelial Dysplasia
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Abstract
Introduction: Nomograms are effective statistical tools that may be integrated into medical practice to calculate treatment outcomes, diagnose diseases, and guide treatment decisions based on patient-specific variables. The current study aimed to develop a novel nomogram to stratify patients with oral epithelial dysplasia (OED) into different risk groups based on their clinic-pathological data. Materials and Methods: Clinico-pathological data of all cases of OED reported during a twelve-year period were retrospectively retrieved. The presence of malignant transformation (MT) among them was confirmed from the departmental cancer registry. Bivariate regression analyses and multivariate logistic regression were used to analyze the risk factors and the role of multiple independent variables, respectively. A p-value < 0.05 was considered statistically significant. An OED nomogram was constructed from the above data. Results: A novel OED nomogram was constructed using three variables - induration, texture, and clinical type. The Receiver operating characteristic (ROC) curve demonstrated an area under the curve (AUC) of 0.753, indicating fair predictive potential. MTR of our study population was 9.8%. Conclusion: The OED nomogram serves as a valuable tool for predicting MT in OED patients. Its application in dental science for stratifying patient risk enables clinicians to plan treatment and follow-up visits efficiently. Keywords: Nomogram; Oral cancer; Oral epithelial dysplasia; Oral potentially malignant disorders.
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13. Warnakulasuriya S, Ramos-García P, González-Moles MÁ. Malignant transformation of oral lichen planus—an umbrella study of systematic reviews. Oral. 2023 Jul 3;3(3):295-306.
14. Nayanar G, Reddy MG, Kakodkar P, Dony EC. Malignant transformation rate of oral submucous fibrosis: A systematic review and meta‐analysis. Oral Surgery. 2023 May;16(2):220-7.
15. Goodson ML, Smith DR, Thomson PJ. The “Newcastle Nomogram”—Statistical modelling predicts malignant transformation in potentially malignant disorders. Journal of Oral Pathology & Medicine. 2019 Sep;48(8):662-8.
16. Zhang X, Kim KY, Zheng Z, Bazarsad S, Kim J. Nomogram for risk prediction of malignant transformation in oral leukoplakia patients using combined biomarkers. Oral Oncology. 2017 Sep 1;72:132-9.
2. Warnakulasuriya S, Ariyawardana A. Malignant transformation of oral leukoplakia: a systematic review of observational studies. Journal of Oral Pathology & Medicine. 2016 Mar;45(3):155-66.
3. Mohideen K, Ghosh S, Krithika C, Ali-Hassan M, Chole R, Dhungel S. Malignant transformation of proliferative Verrucous Leukoplakia—systematic review & meta-analysis. BMC Oral Health. 2025 Feb 1;25(1):175.
4. Tilakaratne WM, Jayasooriya PR, Jayasuriya NS, De Silva RK. Oral epithelial dysplasia: Causes, quantification, prognosis, and management challenges. Periodontology 2000. 2019 Jun;80(1):126-47.
5. Cai X, Zhang J, Han Y, Tang Q, Zhang H, Li T. Development and validation of a nomogram prediction model for malignant transformation of oral potentially malignant disorders. Oral Oncology. 2021 Dec 1;123:105619.
6. Adeoye J, Su YX. Validity of nomograms for predicting cancer risk in oral leukoplakia and oral lichen planus. Oral Diseases. 2024 Jul;30(5):3039-51.
7. Liu J, Song L, Zhou J, Yu M, Hu Y, Zhang J, Song P, Ye Y, Wang J, Feng G, Guo H. Prediction of prognosis of tongue squamous cell carcinoma based on clinical MR imaging data modeling. Technology in Cancer Research & Treatment. 2023 Oct;22:15330338231207006.
8. Lu Q, Yu J, Zhou Y, Zhang Z, Guo L, Bi X. Prediction of postoperative dysphagia in patients with oral cancer: A prospective cohort study. Journal of Stomatology, Oral and Maxillofacial Surgery. 2024 Oct 1;125(5):101957.
9. Wang T, Wang L, Yang H, Lu H, Zhang J, Li N, Guo CB. Development and validation of nomogram for prediction of malignant transformation in oral leukoplakia: A large‐scale cohort study. Journal of Oral Pathology & Medicine. 2019 Jul;48(6):491-8.
10. Speight PM, Khurram SA, Kujan O. Oral potentially malignant disorders: risk of progression to malignancy. Oral surgery, oral medicine, oral pathology and oral radiology. 2018 Jun 1;125(6):612-27.
11. Lorenzo‐Pouso AI, Lafuente‐Ibáñez de Mendoza I, Pérez‐Sayáns M, Pérez‐Jardón A, Chamorro‐Petronacci CM, Blanco‐Carrión A, Aguirre‐Urízar JM. Critical update, systematic review, and meta‐analysis of oral erythroplakia as an oral potentially malignant disorder. Journal of Oral Pathology & Medicine. 2022 Aug;51(7):585-93.
12. Eccles K, Carey B, Cook R, Escudier M, Diniz-Freitas M, Limeres-Posse J, Monteiro L, Silva L, Fricain JC, Catros S, Lodi G. Oral potentially malignant disorders: advice on management in primary care. Journal of Oral Medicine and Oral Surgery. 2022;28(3):36.
13. Warnakulasuriya S, Ramos-García P, González-Moles MÁ. Malignant transformation of oral lichen planus—an umbrella study of systematic reviews. Oral. 2023 Jul 3;3(3):295-306.
14. Nayanar G, Reddy MG, Kakodkar P, Dony EC. Malignant transformation rate of oral submucous fibrosis: A systematic review and meta‐analysis. Oral Surgery. 2023 May;16(2):220-7.
15. Goodson ML, Smith DR, Thomson PJ. The “Newcastle Nomogram”—Statistical modelling predicts malignant transformation in potentially malignant disorders. Journal of Oral Pathology & Medicine. 2019 Sep;48(8):662-8.
16. Zhang X, Kim KY, Zheng Z, Bazarsad S, Kim J. Nomogram for risk prediction of malignant transformation in oral leukoplakia patients using combined biomarkers. Oral Oncology. 2017 Sep 1;72:132-9.
| Files | ||
| Issue | Vol 13, No 3 (Summer 2026) | |
| Section | Original Article(s) | |
| Keywords | ||
| Nomogram; Oral cancer; Oral epithelial dysplasia; Oral potentially malignant disorders. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mahendran I, Krishna R, Cherian L, Narayan V, C R. Development of A Novel Prediction Model for Assessing Malignant Transformation of Oral Epithelial Dysplasia. J Craniomaxillofac Res. 2026;13(3):311-319.
