Prevalence of dysplasia in juvenile-onset recurrent respiratory papillomatosis.
OBJECTIVE
To quantify the prevalence of dysplasia and to evaluate the impact of use of cidofovir in recurrent respiratory papilloma biopsy specimens obtained from a pediatric population.


METHODS
Retrospective review of patient medical records and histopathologic test results from January 1, 1998, through December 31, 2008.


METHODS
Children's Hospital of Wisconsin.


METHODS
Patients with a history of operation treated for recurrent respiratory papillomatosis.


METHODS
The presence or absence of dysplasia identified in a papilloma specimen and patient characteristics, such as age of initial presentation, number of operations, tobacco exposure, treatment for reflux, and use of cidofovir, were quantified.


RESULTS
Treatment for recurrent respiratory papillomatosis was identified in 21 patients. Age at initial diagnosis ranged from 8 months to 14 years. A total of 123 recurrent respiratory papillomatosis specimens in 20 patients were identified. Dysplasia was seen in less than 1% of samples (1/123), which represents 5% of total patients. Seven patients (35%) received cidofovir treatment and none of them developed dysplasia. These data demonstrate a lack of correlation between cidofovir treatment and dysplasia, with the P value being nonsignificant (Fisher exact test, P=.4).


CONCLUSIONS
Dysplasia is a rare event in pediatric recurrent respiratory papillomatosis, and there does not appear to be an association between the use of cidofovir and dysplastic changes.
Sajan
Javad A
JA
Departments of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, USA.
Kerschner
Joseph E
JE
Merati
Albert L
AL
Osipov
Vladimir
V
Szabo
Sara
S
Blumin
Joel H
JH
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D000077404:Cidofovir; D003596:Cytosine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D010212:Papilloma / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D012189:Retrospective Studies; D014922:Wisconsin / Q000453:epidemiology
D000970:Antineoplastic Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir