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Laryngeal dysplasia: a 10-year review of rates of progression to invasive carcinoma and treatment-specific outcomes in a regional ENT department in Northern Ireland

Published online by Cambridge University Press:  18 February 2022

G Donaldson Open the ORCID record for G Donaldson [Opens in a new window] ,
L McCadden ,
S Napier  and
T J Tan
G Donaldson*
Affiliation:
Department of Otolaryngology and Head & Neck Surgery, Royal Victoria Hospital, Belfast, Northern Ireland
L McCadden
Affiliation:
Department of Otolaryngology and Head & Neck Surgery, Royal Victoria Hospital, Belfast, Northern Ireland
S Napier
Affiliation:
Department of Pathology, Royal Victoria Hospital, Belfast, Northern Ireland
T J Tan
Affiliation:
Institute of Cardiovascular Science, University College London, UK
*
Author for correspondence: Dr Gavin Donaldson, Department of Otolaryngology and Head & Neck Surgery, Royal Victoria Hospital, Grosvenor Road, BelfastBT12 6BA, Northern Ireland, UK E-mail: gdonaldson06@qub.ac.uk
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Abstract

Background

Laryngeal dysplasia represents a complex pre-malignant condition characterised by a spectrum of mucosal changes, with a reported malignant transformation rate from dysplasia to invasive carcinoma of 14.0 per cent.

Objective

To identify whether increasing glottic dysplasia severity is associated with higher local malignant transformation rates or adverse clinical outcomes.

Methods

This retrospective cohort study identified 125 patients with any histopathological grade of glottic dysplasia over a 10-year period who were followed up for a standardised 10-year period.

Results

The malignant transformation rate was 21.8 per cent over 10 years, demonstrating a statistically significant greater risk with increasing dysplasia severity. The mean time to transformation was 52 months, with time to transformation statistically associated with increasing dysplasia severity. Rapid progression to carcinoma within 12 months occurred in 40 per cent of cases, and 58 per cent of subsequently diagnosed laryngeal squamous cell carcinomas were tumour stage T1.

Conclusion

Laryngeal dysplasia carries a significant malignant potential, appearing greatest within 12 months of diagnosis and with increasing severity of dysplasia.

Keywords

LarynxVocal CordsLaryngeal NeoplasmsPrecancerous ConditionsEpithelium
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 6 , June 2022 , pp. 547 - 553
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr G Donaldson takes responsibility for the integrity of the content of the paper

Presented orally at the Academic Meeting of the Irish Otolaryngology / Head and Neck Society, 10 October 2020, Dublin, Ireland (virtual meeting).

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