Treatment results in adult-onset recurrent respiratory papillomatosis.
OBJECTIVE
To assess remission rate, treatment results, and factors for remission in patients with adult-onset recurrent respiratory papillomatosis (AORRP).


METHODS
In this retrospective study, the clinical and pathological data of 51 patients with AORRP, treated in University Hospitals between 1972 and 2006 were reviewed. The male-female ratio was 7:3. At diagnosis, the median age was 43 years, and the median retrospective Coltrera-Derkay Staging and Severity score was 6 (range, 2-28). Twenty-one patients (41%) received only surgical treatment. Thirty patients (59%) were treated with surgery and adjuvant intralesional cidofovir.


RESULTS
At the time of analysis in December 2006, 69% of the patients were in remission. Of those, 46% had been treated with adjuvant cidofovir. Of the patients who were not in remission, 87% had been treated with adjuvant cidofovir. This difference was statistically significant (p = 0.005). No significant difference was found between the remission group and the non-remission group for the factors age, gender, smoking habits, alcohol habits, GERD, severity and duration of therapy.


CONCLUSIONS
AORRP was curable in most patients after long intensive treatment, with a general remission rate of 69%. Cidofovir was a negative factor for remission (p = 0.005). No other statistically significant factors for remission were found. Although a control group was present, it was not possible to perform a randomized study with comparable groups. A well-designed placebo-controlled, double-blinded, randomized trial to assess the outcomes of adjuvant intralesional cidofovir therapy for RRP would be valuable.
Verguts
M M L
MM
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium.
Genbrugge
E
E
de Jong
F I C R S
FI
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D007828:Laryngoscopy; D008297:Male; D009364:Neoplasm Recurrence, Local; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D010212:Papilloma / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
D000970:Antineoplastic Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir