Prognostic Role of the Initial Grade of Dysplasia on Premalignant Vocal Fold Lesions

Autores da FMUP

• Carla Isabel Ferreira Pinto Moura

  Autor

Participantes de fora da FMUP

• Pinto, J.

Unidades de investigação

• Patologia

Abstract

Purpose: The main objective of this study was to analyze the prognostic role of the initial grade of dysplasia on the progression to SCC. Study Design: Retrospective cohort. Methods: This study was performed in the Otorhinolaryngology Department of a tertiary hospital center from January 2010 to December 2020. Every patient submitted to a microlaryngoscopy during this period with a histology of dysplasia on the first biopsy was included. Results: A total of 112 patients were included and median follow-up was 24 months (range 1?120 months). Mean age at diagnosis was 59.71 (+/- 12.03) and 88 patients were male (78.6%). Initial grade of dysplasia was mild on 60 patients (53.6%), moderate on 24 (21.4%), severe on 18 (16.1%), and carcinoma in situ in 10 (8.9%). Overall, 25 patients (21.4%) developed invasive squamous cell carcinoma (SCC) and 15 (13.4%) died during follow-up. On an adjusted 5 years progression free survival analysis, considering gender, age, dysplasia grade, tobacco and alcohol consumption, the initial grade of dysplasia was the only factor significantly associated with progression to carcinoma (P = .047). When compared to mild dysplasia, moderate dysplasia had a Hazard Ratio (HR) of 0.81 (95%CI 0.21?3.22); severe dysplasia had a HR of 1.76 (95%CI 0.59?5.30) and carcinoma in situ had a HR of 4.25 (95%CI 1.44?12.59). Conclusion: The initial dysplasia grade seems to be the most important prognostic factor regarding progression to SCC in patients with premalignant vocal fold disease.

Keywords

• Vocal fold; Dysplasia; Laryngeal cancer; Laryngology