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Prevalence and risk factors for dysplasia and malignancy in a large cohort of patients with recurrent respiratory papillomatosis

Published online by Cambridge University Press:  15 November 2024

Bhargavi Chandrasekar*
Affiliation:
ENT Department, Liverpool Head and Neck Centre, Liverpool University Hospital Foundation Trust, Liverpool, UK
Alexandra Bell
Affiliation:
ENT Department, Liverpool Head and Neck Centre, Liverpool University Hospital Foundation Trust, Liverpool, UK
Andrew Kinshuck
Affiliation:
ENT Department, Liverpool Head and Neck Centre, Liverpool University Hospital Foundation Trust, Liverpool, UK
*
Corresponding author: Bhargavi Chandrasekar; Email: [email protected]

Abstract

Objectives

The aim of this study was to evaluate the rate of dysplasia and carcinoma-ex-papillomatosis in patients with recurrent respiratory papillomatosis and assess for any risk factors.

Methods

A 15-year retrospective observational cohort study was performed from a single centre. Data on patient demographics, treatment history and pathology results were extracted from clinical records.

Results

Of the 123 patients identified, nine had juvenile-onset recurrent respiratory papillomatosis and 114 had adult-onset recurrent respiratory papillomatosis. Thirteen (11 per cent) of patients with adult-onset recurrent respiratory papillomatosis had dysplasia, and one patient progressed to carcinoma-ex-papillomatosis. Patients with evidence of dysplasia had an average older age of disease onset compared to those without dysplasia (49 years vs 39 years, p = 0.03).

Conclusion

An older age of recurrent respiratory papillomatosis onset was the only risk factor for dysplasia. Gender, tobacco use, subglottic or tracheal involvement, number of surgeries and cidofovir were not prognostic factors in this series.

Type
Main Article
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Bhargavi Chandrasekar takes responsibility for the integrity of the content of the paper

Presented at North of England Otolaryngology Society Autumn Meeting 2023, Manchester, England, 20 November 2023, and at the 7th Congress on European ORL-HNS, Dublin, Ireland, on 18 June 2024

References

San Giorgi, MRM, van den Heuvel, ER, Tjon Pian Gi, REA, Brunings, JW, Chirila, M, Friedrich, G, et al. Age of onset of recurrent respiratory papillomatosis: a distribution analysis. Clin Otolaryngol 2016;41:448–53Google Scholar
Pim, D, Banks, L. Interaction of viral oncoproteins with cellular target molecules: infection with high-risk vs low-risk human papillomaviruses. APMIS 2010;118:471–93Google Scholar
zur Hausen H. Papillomaviruses and cancer: from basic studies to clinical application. Nat Rev Cancer 2002;2:342–50Google Scholar
Gluvajić, D, Hošnjak, L, Stegel, V, Novaković, S, Gale, N, Poljak, M, et al. Risk factors for the development of high-grade dysplasia and carcinoma in patients with laryngeal squamous cell papillomas: large retrospective cohort study. Head Neck 2021;43:956–66Google Scholar
So, RJ, McClellan, K, Best, SR. Recurrent respiratory papillomatosis: quality of life data from an international patient registry. Laryngoscope 2023;133:1919–26Google Scholar
Novakovic, D, Cheng, ATL, Zurynski, Y, Booy, R, Walker, PJ, Berkowitz, R, et al. A prospective study of the incidence of juvenile-onset recurrent respiratory papillomatosis after implementation of a national HPV vaccination program. J Infect Dis 2018;217:208–12Google Scholar
Teutsch, SM, Nunez, CA, Morris, A, Eslick, GD, Kandaker, G, Berkhout, A, et al. Australian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2019. Commun Dis Intell 2020;45Google Scholar
Donne, AJ, Kinshuck, A. Pharmacotherapy for recurrent respiratory papillomatosis (RRP): a treatment update. Expert Opin Pharmacother 2021;22:1901–8Google Scholar
Carvalho, CM, Huot, L, Charlois, AL, Khalfallah, SA, Chapuis, F, Froehlich, P. Prognostic factors of recurrent respiratory papillomatosis from a registry of 72 patients. Acta Otolaryngol 2009;129:462–70Google Scholar
Karatayli-Ozgursoy, S, Bishop, JA, Hillel, A, Akst, L, Best, SRA. Risk factors for dysplasia in recurrent respiratory papillomatosis in an adult and pediatric population. Ann Otol Rhinol Laryngol 2016;125:235–41Google Scholar
Blumin, JH, Handler, EB, Simpson, CB, Osipov, V, Merati, AL. Dysplasia in adults with recurrent respiratory papillomatosis: incidence and risk factors. Ann Otol Rhinol Laryngol 2009;118:481–5Google Scholar
Donne, AJ, Keltie, K, Cole, H, Sims, AJ, Patrick, H, Powell, S. Prevalence and management of recurrent respiratory papillomatosis (RRP) in the UK: cross-sectional study. Clin Otolaryngol 2017;42:8691Google Scholar
Sims, A, Keltie, K, Belilios, E, Burn, J, Brown, L, Jackson, A, et al. Our experience in developing and operating the Airway Intervention Registry for Recurrent Respiratory Papillomatosis (AIR-RRP): national data collection. NIHR Open Res 2023;2:22Google Scholar
Hartley, C, Hamilton, J, Birzgalis, AR, Farrington, WT. Recurrent respiratory papillomatosis—the Manchester experience, 1974-1992. J Laryngol Otol 1994;108:226–9Google Scholar
Centreforcities. Combined Authority factsheet Liverpool City Region [Internet]. https://www.centreforcities.org/combined-authority/liverpool-city-region/ [3 December 2023]Google Scholar
Welsh Government. Summary statistics for North Wales region: 2020 [Internet]. Stastical First Release. https://www.gov.wales/sites/default/files/statistics-and-research/2020-05/summary-statistics-north-wales-region-2020-806.pdf [accessed 3 December 2023]Google Scholar
Hock, K, Kennedy, A, Howell, R, Friedman, A, de Alarcon, A, Khosla, S. Surgery and adjuvant therapy improve Derkay scores in adult and pediatric respiratory papillomatosis. Laryngoscope 2022;132:2420–6Google Scholar
Preuss, SF, Klussmann, JP, Jungehulsing, M, Eckel, HE, Guntinas-Lichius, O, Damm, M. Long-term results of surgical treatment for recurrent respiratory papillomatosis. Acta Otolaryngol 2007;127:1196–201Google Scholar
Omland, T, Lie, KA, Akre, H, Sandlie, LE, Jebsen, P, Sandvik, L, et al. Recurrent respiratory papillomatosis: HPV genotypes and risk of high-grade laryngeal neoplasia. PLoS One 2014;9:e99114Google Scholar
Khan, M, Naidu, TK. Risk factors associated with severe recurrent respiratory papillomatosis. S Afr J Infect Dis 2019;34:69Google Scholar
Chandran, A, Verma, H, Quadri, JA. Trace elements levels in serum of patients with recurrent respiratory papillomatosis. Indian J Otolaryngol Head Neck Surg 2022;74(suppl 3):5037–43Google Scholar
Hoesli, RC, Thatcher, AL, Hogikyan, ND, Kupfer, RA. Evaluation of safety of intralesional cidofovir for adjuvant treatment of recurrent respiratory papillomatosis. JAMA Otolaryngol Head Neck Surg 2020;146:231–6Google Scholar
Moore, JE, Garcia, A, Sanyal, S, Saunders, S, Portnoy, JE, Hu, A, et al. Degrees of dysplasia based on viral typing in patients with cidofovir use and recurrent respiratory papillomatosis. J Voice 2013;27:765–8Google Scholar
Lee, CJ, Allen, CT, Merati, AL. Prevalence of diabetes mellitus and its impact on disease severity in adult recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg 2013;149:603–7Google Scholar
Hall, JE, Chen, K, Yoo, MJ, Fletcher, KC, Ossoff, RH, Garrett, CG. Natural progression of dysplasia in adult recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg 2011;144:252–6Google Scholar
Davids, T, Muller, S, Wise, JC, Johns, MM 3rd, Klein, A. Laryngeal papillomatosis associated dysplasia in the adult population: an update on prevalence and HPV subtyping. Ann Otol Rhinol Laryngol 2014;123:402–8Google Scholar
Sanchez, GI, Jaramillo, R, Cuello, G, Quintero, K, Baena, A, O’Byrne, A, et al. Human papillomavirus genotype detection in recurrent respiratory papillomatosis (RRP) in Colombia. Head Neck 2013;35:229–34Google Scholar
Freeman, T, Erickson, E, Koch, B, Young, T, Allen, D, Kim, B, et al. Smoking and carcinoma trends in recurrent respiratory papillomatosis patients. Ann Otol Rhinol Laryngol 2023;132:1380–5Google Scholar
Buchinsky, FJ, Valentino, WL, Ruszkay, N, Powell, E, Derkay, CS, Seedat, RY, et al. Age at diagnosis, but not HPV type, is strongly associated with clinical course in recurrent respiratory papillomatosis. PLoS One 2019;14:e0216697Google Scholar
Lele, SM, Pou, AM, Ventura, K, Gatalica, Z, Payne, D. Molecular events in the progression of recurrent respiratory papillomatosis to carcinoma. Arch Pathol Lab Med 2002;126:1184–8Google Scholar
Rosenberg, T, Philipsen, BB, Mehlum, CS, Dyrvig, AK, Wehberg, S, Chirilǎ, M, et al. Therapeutic use of the human papillomavirus vaccine on recurrent respiratory papillomatosis: a systematic review and meta-analysis. J Infect Dis 2019;219:1016–25Google Scholar
British Laryngological Association. Gardasil vaccination in laryngeal papillomatosis – a position statement from the British Laryngological Association [Internet]. https://britishlaryngological.org/gardasil-vaccination-in-laryngeal-papillomatosis-a-position-statement-from-the-british-laryngological-association [accessed 28 January 2023]Google Scholar
Mau, T, Amin, MR, Belafsky, PC, Best, SR, Friedman, AD, Klein, AM, et al. Interim results of a phase 1/2 open-label study of INO-3107 for HPV-6 and/or HPV-11-associated recurrent respiratory papillomatosis. Laryngoscope 2023;133:3087–93Google Scholar