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Analysis of prognostic factors for vocal fold leukoplakia based on 344 cases at a two-year follow up

Published online by Cambridge University Press:  17 May 2023

S Yin
Affiliation:
Department of Otolaryngology, First Affiliated Hospital of Soochow University, Suzhou, China
H Huang
Affiliation:
Department of Otolaryngology, First Affiliated Hospital of Soochow University, Suzhou, China
P Sun*
Affiliation:
Department of Otolaryngology, First Affiliated Hospital of Soochow University, Suzhou, China Department of Head and Neck, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
D Zhang*
Affiliation:
Department of Otolaryngology, First Affiliated Hospital of Soochow University, Suzhou, China
*
Corresponding authors: Dan Zhang; Email: zhangdanent@126.com Peng Sun; Email: entsunpeng@126.com
Corresponding authors: Dan Zhang; Email: zhangdanent@126.com Peng Sun; Email: entsunpeng@126.com

Abstract

Objective

To evaluate risk factors for poor prognosis in vocal fold leukoplakia.

Methods

Clinical data were collected for 344 patients with vocal fold leukoplakia who received surgical treatment in our otolaryngology department from October 2010 to June 2019. Univariate and multivariate logistic regression analyses of the relevant factors were conducted.

Results

Among the 344 patients, 98 exhibited recurrence and 30 underwent a malignant change. Multivariate logistic regression analysis showed that size of the lesion (p = 0.03, odds ratio = 2.14), form of the lesion under white light (p < 0.001), surgical method (p < 0.001, odds ratio = 0.28) and pathological type (p < 0.001) were independent factors that affected the recurrence of vocal fold leukoplakia. In both univariate and multivariate analyses, the sole independent risk factor for malignant transformation of vocal fold leukoplakia was pathological type (p < 0.001).

Conclusion

The outlook for vocal fold leukoplakia depends on several clinical factors, especially pathological type. The more severe the pathological type, the more likely it is to recur or become cancerous.

Type
Main Article
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

*

These authors contributed equally to this work.

Dr D Zhang takes responsibility for the integrity of the content of the paper

References

Fang, Y, Yang, Y, Chen, M, Chen, J, He, P, Cheng, L et al. Correlating intraepithelial papillary capillary loops of vocal cord leukoplakia with histopathology. Acta Otolaryngol 2022;142:106–11CrossRefGoogle ScholarPubMed
Minni, A, Barbaro, M, Rispoli, G, Diaferia, F, Bernardeschi, D, Filipo, R. Treatment with laser CO2 cordectomy and clinical implications in management of mild and moderate laryngeal precancerosis. Eur Arch Otorhinolaryngol 2008;265:189–93CrossRefGoogle ScholarPubMed
Sadri, M, McMahon, J, Parker, A. Management of laryngeal dysplasia: a review. Eur Arch Otorhinolaryngol 2006;263:843–52CrossRefGoogle ScholarPubMed
Fang, Y, Yang, Y, Chen, M, He, P, Cheng, L, Chen, J et al. Elevated peripheral inflammatory markers are related with the recurrence and canceration of vocal fold leukoplakia. Eur Arch Otorhinolaryngol 2019;276:2857–64CrossRefGoogle ScholarPubMed
Boccaccio, C, Medico, E. Cancer and blood coagulation. Cell Mol Life Sci 2006;63:1024–7CrossRefGoogle ScholarPubMed
Young, CK, Lin, WN, Lee, LY, Lee, LA, Hsin, LJ, Liao, CT et al. Laryngoscopic characteristics in vocal leukoplakia: inter-rater reliability and correlation with histology grading. Laryngoscope 2015;125:62–6CrossRefGoogle ScholarPubMed
Chen, M, Li, C, Yang, Y, Cheng, L, Wu, H. A morphological classification for vocal fold leukoplakia. Braz J Otorhinolaryngol 2019;85:588–96CrossRefGoogle ScholarPubMed
Hong, Y, Miao, X, Zhang, X, Ding, F, Luo, A, Guo, Y et al. The role of P53 and MDM2 polymorphisms in the risk of esophageal squamous cell carcinoma. Cancer Res 2005;65:9582–7CrossRefGoogle ScholarPubMed
Yang, SW, Chao, WC, Lee, YS, Chang, LC, Hsieh, TY, Chen, TA et al. Treatment outcome of vocal cord leukoplakia by transoral laser microsurgery. Lasers Med Sci 2017;32:1927CrossRefGoogle ScholarPubMed
Zhou, J, Zhang, D, Zhou, L, Yang, Y, Liu, F, Tao, L et al. Association of the recurrence and canceration rate of vocal leukoplakia with interleukin-10 promoter variants over a 2-year period. Acta Otolaryngol 2016;136:1147–53CrossRefGoogle ScholarPubMed
Klimza, H, Pietruszewska, W, Rosiak, O, Morawska, J, Nogal, P, Wierzbicka, M. Leukoplakia: an invasive cancer hidden within the vocal folds. A multivariate analysis of risk factors. Front Oncol 2021;11:772255Google ScholarPubMed
Wang, M, Zhang, G, Zhang, Y, Cui, X, Wang, S, Gao, S et al. Fibrinogen alpha chain knockout promotes tumor growth and metastasis through integrin-AKT signaling pathway in lung cancer. Mol Cancer Res 2020;18:943–54CrossRefGoogle ScholarPubMed
Sharma, BK, Mureb, D, Murab, S, Rosenfeldt, L, Francisco, B, Cantrell, R et al. Fibrinogen activates focal adhesion kinase (FAK) promoting colorectal adenocarcinoma growth. J Thromb Haemost 2021;19:2480–94CrossRefGoogle ScholarPubMed
Lee, DH, Yoon, TM, Lee, JK, Lim, SC. Predictive factors of recurrence and malignant transformation in vocal cord leukoplakia. Eur Arch Otorhinolaryngol 2015;272:1719–24CrossRefGoogle ScholarPubMed
Zhang, BG, Zhu, JQ, Zhang, W, Su, FX, Wang, GQ, Ni, XG. Effect of a training course on the diagnosis of vocal fold leukoplakia by narrow-band imaging. J Laryngol Otol 2020;134:899904CrossRefGoogle Scholar
Zhang, Y, Liang, G, Sun, N, Guan, L, Meng, Y, Zhao, X et al. Comparison of CO2 laser and conventional laryngomicrosurgery treatments of polyp and leukoplakia of the vocal fold. Int J Clin Exp Med 2015;8:18265–74Google ScholarPubMed
Del Mundo, DAA, Morimoto, K, Masuda, K, Iwaki, S, Furukawa, T, Teshima, M et al. Oncologic and functional outcomes of transoral CO2 laser cordectomy for early glottic cancer. Auris Nasus Larynx 2020;47:276–81CrossRefGoogle ScholarPubMed
Galletti, B, Freni, F, Cammaroto, G, Catalano, N, Gangemi, G, Galletti, F. Vocal outcome after CO2 laser cordectomy performed on patients affected by early glottic carcinoma. J Voice 2012;26:801–5CrossRefGoogle ScholarPubMed
Dispenza, F, De Stefano, A, Marchese, D, Martines, F, Dispenza, C. Management of laryngeal precancerous lesions. Auris Nasus Larynx 2012;39:280–3CrossRefGoogle ScholarPubMed
Gallo, A, de Vincentiis, M, Della Rocca, C, Moi, R, Simonelli, M, Minni, A et al. Evolution of precancerous laryngeal lesions: a clinicopathologic study with long-term follow-up on 259 patients. Head Neck 2001;23:42–73.0.CO;2-1>CrossRefGoogle ScholarPubMed
Weller, MD, Nankivell, PC, McConkey, C, Paleri, V, Mehanna, HM. The risk and interval to malignancy of patients with laryngeal dysplasia; a systematic review of case series and meta-analysis. Clin Otolaryngol 2010;35:364–72CrossRefGoogle ScholarPubMed
Singh, N, Baby, D, Rajguru, JP, Patil, PB, Thakkannavar, SS, Pujari, VB. Inflammation and cancer. Ann Afr Med 2019;18:121–6CrossRefGoogle ScholarPubMed