Laryngeal Dysplasia: Epidemiology and Treatment Outcome

Abstract

A retrospective analysis was undertaken of 65 patients with long-term follow-up for laryngeal squamous dysplasia. Based on the degree of dysplasia demonstrated on initial biopsy, 0 of 6 patients showing hyperkeratosis without dysplasia, 3 of 26 patients (12%) showing mild dysplasia, 5 of 15 patients (33%) showing moderate dysplasia, 4 of 9 patients (44%) showing severe dysplasia, and 1 of 9 patients (11%) showing carcinoma in situ eventually progressed to invasive carcinoma. An analysis was made of the impact of various treatment modalities in 33 patients demonstrating moderate dysplasia, severe dysplasia, or carcinoma in situ. Invasive carcinoma developed in 10 of 21 patients (48%) treated endoscopically and 0 of 12 patients treated by more aggressive therapy, including external beam radiotherapy, partial laryngectomy, or total laryngectomy. Of the patients in the endoscopic therapy group who developed invasive carcinoma, all were salvaged successfully. The overall rate of laryngeal preservation was 15 of 21 patients (71%) in the endoscopic treatment group and 11 of 12 patients (92%) in the aggressive treatment group. This difference is not statistically significant. We conclude that there is a moderately high rate of progression to invasive carcinoma in patients undergoing repeated endoscopic therapy for intraepithelial neoplasms of the larynx. However, with close, long-term follow-up, patients undergoing endoscopic therapy have an overall outcome similar to that in patients treated with partial laryngectomy or radiotherapy prior to developing invasive disease.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

“…Precursor lesions are strongly associated with tobacco smoking and alcohol abuse, and especially a combination of these two (55)(56)(57)(58). The risk of developing these lesions increases with duration of smoking, the type of tobacco and the practice of deep inhalation.…”

Association of laryngeal cancer with vocal cord leukoplakia and associated risk factors in 1,184 patients diagnosed in otorhinolaryngology practices in Germany

“…Corresponding grades of different classification systems were pooled and the following malignant transformation rates were observed: Group of squamous hyperplasia and KWOA, 0-4.1%; group of mild dysplasia, SIN I, LIN I and basal-parabasal hyperplasia, 0-11.5%; group of moderate dysplasia, SIN II and LIN II, 4-24%; and group of severe dysplasia, SIN III, LIN III, atypical hyperplasia and CIS, 9.3-57%. The total transformation rates of all grades together ranged from 2.3% in the authors' own data to 21.4% in a study by Blackwell et al (24). The authors' own data represents the largest study on the topic to date, and reported transformation rates that were substantially lower compared with previous studies: 1.1% in squamous hyperplasia and basal/parabasal cell hyperplasia, 9.5% in atypical hyperplasia and 2.3% in all grades combined.…”

Prognostic Significance of Fhit and Wwox Proteins Expression in Laryngeal Cancer

“…After skin cancer, laryngeal cancer is the second most common cancer in the head and neck region [1]. There are various treatment methods for cancer treatment; however, patients' responses to these treatments may not always be the same.…”