Relationship of Leukoplakia to Urothelial Malignancy

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Abstract
The records of 108 patients presenting with leukoplakia of the urinary tract during the last 35 yr were reviewed to define the natural history of this disease, with emphasis upon its association with urothelial cancer. Of the 108 patients 24 had upper urinary tract, 78 bladder and 10 urethral leukoplakia (1 with renal and bladder involvement, 3 with bladder and urethral involvement, and 1 with ureteral and renal involvement). Presenting complaints were primarily irritative. To date, 41 patients (37%) have had associated carcinoma of the urothelium: 23 (21%) presented with a concomitant or previous carcinoma and 18 of 85 (21%) presenting without a concomitant or previous neoplasm have had documented progression to cancer. These figures support the concept that leukoplakia is a premalignant disease and that patients with this diagnosis deserve careful and frequent followup.