Long-term results of surgical treatment for recurrent respiratory papillomatosis

Abstract

In all, 64 patients (33%) underwent a total of 137 operations using the CO2 laser; 130 patients (67%) underwent a total of 565 microlaryngeal operations by surgery with cold instruments. Five percent of the patients treated with conventional microlaryngeal surgery and none of the patients treated with laser surgery required tracheostomy (p<0.05). Postoperative glottic webs and scar formations were found in 6% of all patients after laser surgery and 20% after conventional surgery (p<0.05). The different methods of treatment did not affect the rate of recurrence (p=0.61) Malignant transformation or secondary airway carcinoma were observed in 4% of all patients.

Integration of HPV6 and Downregulation of AKR1C3 Expression Mark Malignant Transformation in a Patient with Juvenile-Onset Laryngeal Papillomatosis

“…The reported incidence of carcinoma developing in RRP patients varies from 0% to 22% [3], [10]. In our own series of patients treated at the University of Cologne, the incidence of airway carcinoma was 4.6% [11].…”

Rare case of malignant transformation of recurrent respiratory papillomatosis associated with human papillomavirus type 6 infection and p53 overexpression

“…A malignant transformation rate of 1.7% was reported in a series of 179 patients (Klozar et al 1997), and malignant transformation or secondary airway carcinoma were observed in 4% of 194 patients in another large-scale study (Preuss et al 2007). …”

“…In juvenile-onset cases, a number of different drugs have previously been used as adjuvant therapy, including antiviral agents, interferon, retinoids (Katsenos & Becker 2011; Gallagher & Derkay 2009) and cidofovir, but their efficacies are limited (Shehab et al 2005; Kimberlin & Malis 2000). Surgical removal of respiratory tract papilloma is the primary treatment for RRP, but it is also used as palliative treatment for the prevention of severe dyspnea and stridor (Bergler & Gotte 2000; Preuss et al 2007). Thus, many patients require multiple surgeries and each episode of surgery or surgical trauma can result in the reemergence or worsening of the papillomas (Preuss et al 2007).…”

“…Surgical removal of respiratory tract papilloma is the primary treatment for RRP, but it is also used as palliative treatment for the prevention of severe dyspnea and stridor (Bergler & Gotte 2000; Preuss et al 2007). Thus, many patients require multiple surgeries and each episode of surgery or surgical trauma can result in the reemergence or worsening of the papillomas (Preuss et al 2007). …”

Identification of the murine H-2Db and human HLA-A*0201 MHC class I-restricted HPV6 E7-specific cytotoxic T lymphocyte epitopes

“…Clinically, all patients diagnosed with RRP have recurrent growths of papilloma within their upper aerodigestive tract and the primary treatment modality is surgical debulking of the lesions, as no effective cures have been developed to date. Over 50% of RPP patients will require multiple surgical interventions over their lifetime to manage the symptoms associated with their disease burden [3]. Given the importance of the immune system in eradicating HPV infections and associated lesions, we are interested in developing targeted immunotherapies against HPV types 6 and 11 with a goal of finding a definitive cure for RRP.…”