Abstract
The best management of the oral potentially malignant disorders (OPMDs) remains uncertain particularly when subdivided into the levels of dysplasia. This retrospective cohort study involved 200 cases of patients who were compared with regard to malignant transformation and recurrence of malignancies between surgical excision and active surveillance. It was established that surgical excision had a substantially lower transformation risk, especially in moderate-to-severe dysplasia and had better malignancy-free survival on KaplanMeier analysis. Repeated cases were seen in both groups, but surveillance and high-grade dysplasia were found to be an independent powerful predictor of malignant progression. Thus, surgical excision offers meaningful protection in the transforming process and should be given priority with high-risk OPMDs to minimise the transition to OSCC.