Recurrent lesion distribution after photodynamic therapy for recurrent respiratory papillomatosis.
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BACKGROUND: Recurrent respiratory papillomatosis (RRP) is a benign laryngeal tumor, and traditional surgical resection faces the dilemma between excessive tissue removal and high recurrence rates. Photodynamic therapy (PDT), as a "regional clearance" strategy, offers a novel approach to addressing this challenge. However, the anatomical distribution of recurrent lesions following PDT has not been fully elucidated. OBJECTIVE: To evaluate the distribution characteristics of recurrent lesions in different anatomical regions following PDT for RRP, thereby providing evidence to optimize PDT treatment protocols. METHODS: A retrospective study analyzed 43 RRP patients who underwent PDT (January 2021-December 2024), with 54 recurrence records examined. Postoperative laryngoscopic examinations were performed monthly to assess recurrence. An 11-region anatomical diagram was used to assess lesion distribution and calculate relative recurrence rates across anterior and posterior regions. In-situ and ectopic recurrences were statistically compared. RESULTS: The study found that the epiglottis exhibited the highest relative recurrence rate (75.00 %), indicating it is more prone to recurrence than other regions (χ² = 21.850, P = 0.016). Additionally, the recurrence rate in the posterior regions (63.16 %) was higher than that in the anterior regions (50.00 %) (χ² = 3.54, P = 0.060). Furthermore, in-situ recurrence significantly outweighed ectopic recurrence (χ² = 111.24, P < 0.001). CONCLUSION: During PDT for RRP, statistically significant differences in relative recurrence rates were observed across anatomical regions, with in-situ recurrence being the most common pattern.