title: Clinical course of recurrent respiratory papillomatosis: comparison between aggressiveness of human papillomavirus-6 and human papillomavirus-11.
abstract: BACKGROUND
  Recurrent respiratory papillomatosis (RRP) is mainly associated with human papillomavirus (HPV)6 or HPV11. The purpose of this study was to compare clinical outcome, aggressiveness, and treatment response between HPV6- and HPV11-associated RRP.
  
  
  METHODS
  A retrospective cohort of 55 patients with RRP (1974-2012) was used. Surgical interventions (n = 814) were analyzed, and complications scored. HPV6/11-specific polymerase chain reaction (PCR) was performed on RRP biopsies.
  
  
  RESULTS
  Seventy-six percent of patients (42 of 55) were infected with HPV6 and 24% (13 of 55) with HPV11. The HPV11 group had anatomically more widespread disease. The expected number of surgical interventions was higher in the younger age (<22.4 years) HPV11 group, and the older age (<22.4 years) HPV6 group. Regardless of HPV type, earlier age of onset of RRP resulted in a higher number of surgical interventions.
  
  
  CONCLUSIONS
  Anatomically, HPV11-associated RRP behaves more aggressively. Younger patients with HPV11 and older patients with HPV6 experience a worse clinical course of RRP.
authors: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Robin E A
authors: RE
authors: Tjon Pian Gi
authors: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Michel R M
authors: MR
authors: San Giorgi
authors: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Lorian
authors: L
authors: Slagter-Menkema
authors: Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Bettien M
authors: BM
authors: van Hemel
authors: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Bernard F A M
authors: BF
authors: van der Laan
authors: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Edwin R
authors: ER
authors: van den Heuvel
authors: Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Frederik G
authors: FG
authors: Dikkers
authors: Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, The Netherlands.
authors: Ed M D
authors: EM
authors: Schuuring
mesh_terms: D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D015331:Cohort Studies; D005260:Female; D006785:Hospitals, University; D052140:Human papillomavirus 11 / Q000302:isolation & purification*; D052163:Human papillomavirus 6 / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D009426:Netherlands; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery / Q000821:virology*; D016133:Polymerase Chain Reaction / Q000379:methods; D011379:Prognosis; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery / Q000821:virology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D055815:Young Adult
keywords: HPV; HPV11; clinical course; human papillomavirus, HPV6; recurrent respiratory papillomatosis