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