KBB-Forum 2020 , Cilt 19, Sayı 1

RISK FOR PROGRESSION TO INVASIVE CARCINOMA IN PATIENTS WITH VOCAL CORD DYSPLASTIC LESIONS: LONG-TERM FOLLOW-UP RESULTS

Dr. Mehmet Özgür PINARBAŞLI1, Dr. Melek Kezban GÜRBÜZ1, Dr. Tankut UZUN1, Dr. Fatma KAYA2, Dr. Mustafa AÇIKALIN2, Dr. Ercan KAYA1, Dr. Erkan ÖZÜDOĞRU1
1Esogü Tıp Fakültesi, KBB, Eskişehir, Türkiye
2Esogü Tıp Fakültesi, Patoloji, Eskişehir, Türkiye Objectives: Early diagnosis and treatment of larynx cancers determine the survival of the patient. Dysplastic larynx lesions are an important predisposing factor for larynx cancers. Therefore, close follow-up of patients with dysplastic lesions in vocal cords is required. In this study, patients with vocal cord dysplastic lesions (dysplasia, carcinoma in situ) were examined retrospectively and the aim of this study was to determine the incidence and causes of invasive carcinoma in long term follow up.

Material- Methods: 92 patients who underwent biopsy with direct laryngoscopy between January 2010 and January 2019 and whose pathology results were reported as dysplasia and carcinoma in situ were retrospectively analyzed. Demographic characteristics, smoking history, follow-up period, and invasive carcinoma progressing rates of the lesions were determined.

Results: Of the 92 patients with vocal cord dysplastic lesions, 89 (96.7%) were male and 3 (3.3%) were female. The mean age was 65 (32-89) years. Pathology results of the patients were examined. It was observed that 20 (21.7%) patients were diagnosed as carcinoma in situ and 72 (78.3%) patients were diagnosed as various grade dysplasia. When the patients with dysplasia were classified, 18 (25%) were "severe grade", 26 (36.1%) were "moderate", and 28 (38.9%) were "mild". The mean follow-up period was 28 months. During the follow-up, 10 (10.8%) patients progressed invasive carcinoma. In 3 (15%) of 20 patients with carcinoma in situ, in 3 (16.6%) of 18 patients with severe grade dysplasia, in 2 (7.7%) of 26 patients with moderate dysplasia, in 2 (7.1%) of 28 patients with mild dysplasia were found to progressing invasive carcinoma.

Conclusion: Dysplastic larynx lesions are a predisposing factor for the development of laryngeal cancer. Particularly, patients with "carcinoma in situ" and "severe-grade dysplasia" should be kept under close monitoring because of the risk of invasive carcinoma. These patients should be followed up with videolaryngostroboscopy and diagnosis and treatment should be planned according to changes in lesion morphology and size. Keywords : Carcinoma in situ, Dysplasia, Invasive Carcinoma, Larynx, Vocal cord