Nationwide Survey on Recurrent Respiratory Papillomatosis in Japan: Analysis of Long-Term Patients.
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OBJECTIVES: To investigate the long-term disease status, clinical course, laryngeal distribution, management, and postoperative recurrence of recurrent respiratory papillomatosis (RRP) diagnosed before the first nationwide survey in Japan. METHODS: As described in our previous report, we conducted a questionnaire-based survey targeting 782 institutions, asking about the presence of RRP patients during the survey period in 2018 and 2019. A detailed questionnaire was subsequently sent to the 196 institutions that reported having at least one patient, inquiring about age, sex, history of recent surgery, Derkay's score, surgical procedures, and postoperative recurrence. The present study analyzed data from patients who had been diagnosed prior to the beginning of the survey period. RESULTS: Data on 318 previously diagnosed patients were collected from 90 institutions. At their first follow-up visit during the survey period, 85 patients (26.7%) had a Derkay's anatomical score of 0. The true vocal folds were the most commonly affected laryngeal subsites. Of the 318 patients, 165 underwent surgery after the first follow-up visit, and recurrence occurred in 106 after this surgery. The 6- and 12-month additional surgery-free rates were 58.9% and 31.8%. These rates were significantly higher in patients who had undergone one or no surgery within a year prior to the first follow-up visit during the survey period than in those who had undergone two or more surgeries (p = 0.01). CONCLUSION: The present study revealed real-world data suggesting that the number of recent surgeries and Derkay's anatomical score may be associated with the clinical course of previously diagnosed RRP.