TY - JOUR
T1 - Laryngeal dysplasia, demographics, and treatment
T2 - A single-institution, 20-year review
AU - Karatayli-Ozgursoy, Selmin
AU - Pacheco-Lopez, Paulette
AU - Hillel, Alexander T.
AU - Best, Simon R.
AU - Bishop, Justin A.
AU - Akst, Lee M.
N1 - Publisher Copyright:
© 2015 American Medical Association. All rights reserved.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - IMPORTANCE: Laryngeal dysplasia is a common disease entity that remains clinically frustrating because functional outcomes are balanced against oncologic results. Understanding evolution in dysplasia demographics, treatment, and progression ratesmay inform better therapy in the future. OBJECTIVES: To review laryngeal dysplasia cases at a single institution during the last 20 years and identify changes in patient demographics, categorize treatment approaches, and review rates of progression to cancer. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective medical record review, patients with laryngeal dysplasia treated at an academic medical center were identified on review of pathology records. INTERVENTIONS Patients were organized by date of dysplasia diagnosis, divided into 2 groups (group 1, January 1, 1993, through December 31, 2002; group 2, January 1, 2003, through December 31, 2012), and compared against one another. MAIN OUTCOMES AND MEASURES: Age at diagnosis, sex, type of treatment, and progression to malignant disease were analyzed from one period to the next. RESULTS: A total of 107 patients were identified through review of pathology databases. Progression of dysplasia to cancer remained roughly stable across periods, at 8.8% and 8.0%, respectively. Mean age at diagnosis decreased from 68.7 to 61.7 years over time, with a statistically significant trend toward presentation at younger ages. The male to female ratio was 3.75 in group 1 and 3.17 in group 2, with a trend toward a greater proportion of females over time that did not reach statistical significance. Use of radiotherapy remained stable across groups, with increased use of microflap excision techniques and laser treatment (especially photoangiolytic lasers) in group 2. CONCLUSIONS AND RELEVANCE: Overall, progression of laryngeal dysplasia to cancer has remained stable during the past 20 years at a rate of approximately 8%. Although laryngeal dysplasia remains a disease predominantly found in males, there is a demographic trend toward diagnosis at earlier ages. Treatment choicesmay slowly be changing over time, although multi-institutional studiesmay be required to better categorize this shift.
AB - IMPORTANCE: Laryngeal dysplasia is a common disease entity that remains clinically frustrating because functional outcomes are balanced against oncologic results. Understanding evolution in dysplasia demographics, treatment, and progression ratesmay inform better therapy in the future. OBJECTIVES: To review laryngeal dysplasia cases at a single institution during the last 20 years and identify changes in patient demographics, categorize treatment approaches, and review rates of progression to cancer. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective medical record review, patients with laryngeal dysplasia treated at an academic medical center were identified on review of pathology records. INTERVENTIONS Patients were organized by date of dysplasia diagnosis, divided into 2 groups (group 1, January 1, 1993, through December 31, 2002; group 2, January 1, 2003, through December 31, 2012), and compared against one another. MAIN OUTCOMES AND MEASURES: Age at diagnosis, sex, type of treatment, and progression to malignant disease were analyzed from one period to the next. RESULTS: A total of 107 patients were identified through review of pathology databases. Progression of dysplasia to cancer remained roughly stable across periods, at 8.8% and 8.0%, respectively. Mean age at diagnosis decreased from 68.7 to 61.7 years over time, with a statistically significant trend toward presentation at younger ages. The male to female ratio was 3.75 in group 1 and 3.17 in group 2, with a trend toward a greater proportion of females over time that did not reach statistical significance. Use of radiotherapy remained stable across groups, with increased use of microflap excision techniques and laser treatment (especially photoangiolytic lasers) in group 2. CONCLUSIONS AND RELEVANCE: Overall, progression of laryngeal dysplasia to cancer has remained stable during the past 20 years at a rate of approximately 8%. Although laryngeal dysplasia remains a disease predominantly found in males, there is a demographic trend toward diagnosis at earlier ages. Treatment choicesmay slowly be changing over time, although multi-institutional studiesmay be required to better categorize this shift.
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U2 - 10.1001/jamaoto.2014.3736
DO - 10.1001/jamaoto.2014.3736
M3 - Article
C2 - 25654369
AN - SCOPUS:84928476288
SN - 2168-6181
VL - 141
SP - 313
EP - 318
JO - JAMA Otolaryngology - Head and Neck Surgery
JF - JAMA Otolaryngology - Head and Neck Surgery
IS - 4
ER -