Dysplasia in Adults with Recurrent Respiratory Papillomatosis: Incidence and Risk Factors

Blumin, Joel H.; Handler, Ethan B.; Simpson, C. Blake; Osipov, Vladimir; Meratı, Albert L.

doi:10.1177/000348940911800704

Cited by 32 publications

(43 citation statements)

References 11 publications

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“…We report a male preponderance among AoRRP patients, which is consistent with earlier published studies 17, 23. A similar sex disparity is well documented for oropharyngeal cancer 8, 24.…”

Section: Discussionsupporting

confidence: 92%

Epidemiological aspects of recurrent respiratory papillomatosis: A population‐based study

et al. 2012

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Objectives/Hypothesis:The incidence of genital infections, cervical cancer, and oropharyngeal cancer induced by human papillomaviruses (HPV) is increasing in Western countries. Primarily, this study was conducted to estimate the incidence rate of recurrent respiratory papillomatosis (RRP) in juveniles and adults in two Norwegian subpopulations for each year between 1987 and 2009. The secondary objective of the study was to investigate whether there are trends in the incidence rates of RRP in the study period similar to what we have seen for HPV‐related cancer.Study Design:Population‐based study.Methods:Two Norwegian subpopulations with 2.6 million and 1.1 million inhabitants were investigated for the juvenile and adult forms of RRP, respectively, between the years of 1987 and 2009. Patients treated for RRP were identified in all ear/nose/throat departments located in the two areas.Results:The overall incidence rates of RRP in juveniles and adults were 0.17 (95% confidence interval [CI], 0.10–0.25) and 0.54 (95% CI, 0.44–0.65) per 100,000, respectively. We found a preponderance of males in both groups (P = .000 for adults and P = .038 for children). There was no significant change in the yearly incidence rate during the study period, for either adults or children, even when stratifying for gender in each group. The median age at onset was 4 years for children and 34 years for adults, with no significant difference between genders, nor significant changes during the study years.Conclusions:This study does not support our hypothesis of an increasing incidence of RRP, for either children or adults. The estimated incidence rates in the Norwegian subpopulations are consistent with former population‐based studies. Male preponderance in children was an unexpected finding. Further studies are warranted. Laryngoscope, 2012

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“…We report a male preponderance among AoRRP patients, which is consistent with earlier published studies 17, 23. A similar sex disparity is well documented for oropharyngeal cancer 8, 24.…”

Section: Discussionsupporting

confidence: 92%

Epidemiological aspects of recurrent respiratory papillomatosis: A population‐based study

et al. 2012

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“…Use of cidofovir requires the surgeon and patient to understand the medication's potential for adverse effects on renal function, hepatic function, hematopoiesis, and on the endolarynx. The toxicities of cidofovir, as well as its relationship to laryngeal mucosal dysplasia and neoplasia in the setting of RRP have been reviewed 12…”

Section: Resultsmentioning

confidence: 99%

Current use of intralesional cidofovir for recurrent respiratory papillomatosis

et al. 2012

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Eighteen statements were approved by the RRP Task Force after discussion of the survey results. Intralesional cidofovir may be initiated if surgical debulking is required every 2 to 3 months. The concept of an adjuvant regimen with regular biopsy is favored. Administration should remain below established safe limits of dosing (3 mg/kg) and volume. Informed consent, including discussion of off-label use and acute kidney injury in children, is important. A special consent form sample is included. There remains a need for high-quality data.

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“…It is challenging to compare our results with previous studies due to varying terminology and end-points. [54], [55] We applied a dual classification system, which separates low-and high-grade neoplasia, widely used in reporting histopathological findings in the anogenital tract. In a cohort of 129 patients with RRP, Sanchez et al [6] reported a total incidence of 13.2% for moderate and severe dysplasias, a figure not dissimilar from our own.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Respiratory Papillomatosis: HPV Genotypes and Risk of High-Grade Laryngeal Neoplasia

et al. 2014

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Patients with recurrent respiratory papillomatosis (RRP) in Norway treated between 1987 and 2009 were recruited to this cohort study. They were followed from disease onset and data recorded until January 2012. Here, we describe the distribution of human papillomavirus (HPV) genotypes, the prevalence of multiple HPV infections, and the risk of high-grade laryngeal neoplasia and respiratory tract invasive carcinoma in a large cohort of patients with RRP. We also examined whether HPV genotype, gender, age or clinical course are risk factors for this development. Clinical records and histological specimens were reviewed. Using formalin-fixed paraffin-embedded biopsies, HPV genotyping were performed by quantitative polymerase chain reaction assays identifying 15 HPV types. HPV-negative specimens were analyzed by metagenomic sequencing. Paraffin blocks were available in 224/238 patients. The DNA quality was approved in 221/224 cases. HPV DNA was detected in 207/221 patients and all were HPV 6 or HPV 11 positive, comprising HPV 6 in 133/207, HPV 11 in 40/207 cases and HPV 6/11 in 15/207 cases. Co-infection with one or two high-risk HPV types together with HPV 6 or HPV 11 was present in 19/207 patients. Metagenomic sequencing of 14 HPV-negative specimens revealed HPV 8 in one case. In total, 39/221 patients developed high-grade laryngeal neoplasia. 8/221 patients developed carcinoma of the respiratory tract (six patients with laryngeal carcinoma and two patients with lung carcinoma). High-grade laryngeal neoplasias were found more frequently in HPV-negative versus HPV-positive patients, (RR = 2.35, 95% CI 1.1, 4.99), as well as respiratory tract carcinomas (RR = 48, 95% CI 10.72, 214.91). In summary, the majority of RRP were associated with HPV 6 and/or 11. HPV-negative RRP biopsies occurred more frequently in adult-onset patients, and were associated with an increased risk of laryngeal neoplasia and carcinoma in the respiratory tract.

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Dysplasia in Adults with Recurrent Respiratory Papillomatosis: Incidence and Risk Factors

Abstract: Dysplasia was discovered in more than 20% of adult patients with RRP studied over a 6-year period. Age, gender, tobacco history, and operative frequency were not identifiable risk factors for the presence of dysplasia.

Cited by 32 publications

References 11 publications

Epidemiological aspects of recurrent respiratory papillomatosis: A population‐based study

Epidemiological aspects of recurrent respiratory papillomatosis: A population‐based study

Current use of intralesional cidofovir for recurrent respiratory papillomatosis

Recurrent Respiratory Papillomatosis: HPV Genotypes and Risk of High-Grade Laryngeal Neoplasia

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