Laryngeal dysplasia: Oncological outcomes in a large cohort of patients treated in a tertiary comprehensive cancer centre

Am J Otolaryngol. 2021 Mar-Apr;42(2):102861. doi: 10.1016/j.amjoto.2020.102861. Epub 2021 Jan 4.

Abstract

Purpose: Laryngeal dysplasia represents a series of precancerous lesions, observed as laryngeal leukoplakia. General agreement has been lacking for their management and treatment ranging from simple biopsy to complete excision with cold blade/laser. In this work, we aim at providing the oncological outcomes of patients affected by laryngeal dysplasia, treated with a single modality, and at identifying clinical parameters predictive of malignant transformation.

Materials and methods: We performed a retrospective analysis of patients treated with transoral laser microsurgery between January 2005 and December 2015 in a tertiary comprehensive cancer centre. Data were collected about smoke and alcohol habits, site of the laryngeal lesion, surgical outcomes and progression to invasive squamous cell carcinoma.

Results: The grade of dysplasia, margins' status and smoke habit were not associated with a significantly worse DFS and a higher risk of invasive SCC. We identified three parameters (supraglottic involvement, multifocality and history of more than one recurrence of dysplasia) that have a significant prognostic value.

Conclusions: On the base of these clinical parameters, a more intensive follow-up might be warranted for high-risk patients.

Keywords: Laryngeal cancer; Laryngeal dysplasia; Precancerous lesion; Transoral laser microsurgery.

MeSH terms

  • Cancer Care Facilities / statistics & numerical data*
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / etiology
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy*
  • Cell Transformation, Neoplastic*
  • Disease Progression
  • Female
  • Humans
  • Laryngeal Neoplasms / epidemiology
  • Laryngeal Neoplasms / etiology
  • Laryngeal Neoplasms / pathology*
  • Laryngeal Neoplasms / therapy*
  • Male
  • Odds Ratio
  • Precancerous Conditions*
  • Retrospective Studies
  • Risk
  • Smoking / adverse effects
  • Tertiary Care Centers / statistics & numerical data*
  • Treatment Outcome