PONE-D-19-26374

Recurrence rates after surgical removal of oral leukoplakia - a prospective longitudinal multi-centre study

PLOS ONE

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PLOS ONE

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Reviewers' comments:

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: I Don't Know

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: The authors have carried out a very interesting study to determine the causes for recurrence of oral Leukoplakias

The study has been carried out in a very systematic manner,

Oral leukoplakia with dysplasia are potentially premalignant lesions. In the current study the number of cases with dysplasias that is selected are only 22. More number of cases with dysplasias can be evaluated and the recurrence rate and causes for recurrences for these cases should be determined. This will help in identifying high-risk lesions and they can be treated appropriately.

The Kaplan - Meier survival curves are also very interesting. It is interesting to note that the habit of snuff is a causative factor for recurrence.

Reviewer #2: This is an interesting and well performed study on recurrence of oral leukoplakias (OL) following surgical excision. I have only three comments:

1. A definition of oral leukoplakia is given in the introduction, however, I think the definition used by the participating centers should be given also in the patients and methods section.

2. On page 4/5 it is stated that “the inclusion criterion was a clinically and histopathologically verified diagnosis of OL”. Traditionally, histopathology cannot verify an OL, however, the biopsy can rule out other diagnoses and give information on possible epithelial dysplasia/carcinoma. I am sure the authors are aware of this, however, in order not to mislead others, I think the sentence should be changed.

3. In Table 1 lichenoid reaction is given as the histopathological diagnosis in 20 cases. Three questions emerge from this:

a. is this compatible with a final diagnosis of leukoplakia? A short discussion could be included.

b. lichenoid reactions are sometimes seen in relation to contact with dental restorations or other causes. Were there any clinical indications that the cases with histopathologically diagnosed lichenoid reactions had an obvious (or possible) cause such as contact with dental restorations? I think a short mentioning of this should appear in the patients and methods section.

c. how many recurrences were seen in these cases?

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Reviewer #1: Yes: Dr Monica Charlotte Solomon

Reviewer #2: No

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Recurrence rates after surgical removal of oral leukoplakia - a prospective longitudinal multi-centre study

PONE-D-19-26374R1

Dear Dr. Hasséus,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

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With kind regards,

Muy-Teck Teh, Ph.D.

Academic Editor

PLOS ONE

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