title: Laryngeal dysplasia, demographics, and treatment: a single-institution, 20-year review.
abstract: OBJECTIVE
  Laryngeal dysplasia is a common disease entity that remains clinically frustrating because functional outcomes are balanced against oncologic results. Understanding evolution in dysplasia demographics, treatment, and progression rates may inform better therapy in the future.
  
  
  OBJECTIVE
  To review laryngeal dysplasia cases at a single institution during the last 20 years and identify changes in patient demographics, categorize treatment approaches, and review rates of progression to cancer.
  
  
  METHODS
  In this retrospective medical record review, patients with laryngeal dysplasia treated at an academic medical center were identified on review of pathology records.
  
  
  METHODS
  Patients were organized by date of dysplasia diagnosis, divided into 2 groups (group 1, January 1, 1993, through December 31, 2002; group 2, January 1, 2003, through December 31, 2012), and compared against one another.
  
  
  METHODS
  Age at diagnosis, sex, type of treatment, and progression to malignant disease were analyzed from one period to the next.
  
  
  RESULTS
  A total of 107 patients were identified through review of pathology databases. Progression of dysplasia to cancer remained roughly stable across periods, at 8.8% and 8.0%, respectively. Mean age at diagnosis decreased from 68.7 to 61.7 years over time, with a statistically significant trend toward presentation at younger ages. The male to female ratio was 3.75 in group 1 and 3.17 in group 2, with a trend toward a greater proportion of females over time that did not reach statistical significance. Use of radiotherapy remained stable across groups, with increased use of microflap excision techniques and laser treatment (especially photoangiolytic lasers) in group 2.
  
  
  CONCLUSIONS
  Overall, progression of laryngeal dysplasia to cancer has remained stable during the past 20 years at a rate of approximately 8%. Although laryngeal dysplasia remains a disease predominantly found in males, there is a demographic trend toward diagnosis at earlier ages. Treatment choices may slowly be changing over time, although multi-institutional studies may be required to better categorize this shift.
authors: Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland.
authors: Selmin
authors: S
authors: Karatayli-Ozgursoy
authors: Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland.
authors: Paulette
authors: P
authors: Pacheco-Lopez
authors: Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland.
authors: Alexander T
authors: AT
authors: Hillel
authors: Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland2Milton J. Dance Jr Head and Neck Center, Johns Hopkins Voice Center, Baltimore, Maryland.
authors: Simon R
authors: SR
authors: Best
authors: Department of Pathology, Johns Hopkins University, Baltimore, Maryland.
authors: Justin A
authors: JA
authors: Bishop
authors: Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland2Milton J. Dance Jr Head and Neck Center, Johns Hopkins Voice Center, Baltimore, Maryland.
authors: Lee M
authors: LM
authors: Akst
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011230:Precancerous Conditions / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors