In this retrospective study, authors assess the rate of dysplasia progression to invasive cancer in a cohort of 221 patients presenting with primary laryngeal dysplasia, followed over a period of over 13 years. Patient demographics and independent risk factors for cancer progression were statistically identified. The results were compared with several earlier studies on similar cohorts. Dysphonia was the usual symptom. Hypertension, coronary artery disease and diabetes were the commonest comorbidities. Forty percent of these patients smoked and 19% consumed alcohol. Cancer progression was identified in 26 patients (11.7%), the median time to progression being 24 months. Patients with carcinoma in situ showed significantly higher malignant transformation rates in comparison to those with mild dysplasia, this being consistent with a previous meta-analysis. Laser excision was applied to those with good exposure on direct laryngoscopy. Others underwent partial laryngectomy procedures. Patients with dysplasia involving the anterior commissure had a rate of malignant transformation eight times higher. This is attributed to anatomic and diagnostic complexity of this region. A targeted management plan is therefore advised.
An analysis of laryngeal dysplasia cases in terms of progression to invasive cancer
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