Treatment outcome of vocal cord leukoplakia by transoral laser microsurgery.
The aim of this study is to evaluate the treatment outcome and analyze the associated factors of postoperative recurrence in patients who received transoral laser microsurgery for vocal cord leukoplakia. The demographic, histopathological data were retrospectively reviewed and the factors associated with recurrence of vocal leukoplakia after surgery were analyzed statistically. A total of 44 patients, including 36 males and 8 females, with a mean age of 50.4 ± 13.4 years, were enrolled. All the patients received excision of the vocal leukoplakia by carbon dioxide laser (2-4 Watt, ultrapulse mode) under general anesthesia. No patients had malignant transformation after surgery. Postoperative recurrence occurred in 10 patients (22.7 %). Univariate analysis showed that patients who had the habit of cigarette smoking, alcohol drinking, and presence of gastroesophageal reflux disease tended to recur. Among these risk factors, presence of gastroesophageal reflux disease (odds ratio 8.43) was the independent prognostic factor for recurrence using multivariate logistic regression analysis. Carbon dioxide laser excision is effective for treating vocal leukoplakia that is still confined to dysplasia of any degree, with acceptable morbidity. This study suggests that the presence of gastroesophageal reflux disease is the prognostic indicator for postoperative recurrence of vocal leukoplakia. Aggressive treatment of reflux disease for those who have received surgical excision for vocal leukoplakia is indicated.
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung. No. 222, Mai Chin Road, Keelung 204, Taiwan.|School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Shih-Wei
SW
Yang
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung. No. 222, Mai Chin Road, Keelung 204, Taiwan.|School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Wei-Chieh
WC
Chao
Genomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.|Department of Biotechnology, Ming Chuan University, Tao-Yuan, Taiwan.
Yun-Shien
YS
Lee
School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.|Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Liang-Che
LC
Chang
School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.|Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Tsan-Yu
TY
Hsieh
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung. No. 222, Mai Chin Road, Keelung 204, Taiwan.|School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Tai-An
TA
Chen
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung. No. 222, Mai Chin Road, Keelung 204, Taiwan. lcm3647@gmail.com.|School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan. lcm3647@gmail.com.
Cheng-Ming
CM
Luo
D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D007971:Leukoplakia / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology* / Q000601:surgery*
Alcohol; Carbon dioxide laser; Gastroesophageal reflux disease; Smoking; Transoral laser microsurgery; Vocal cord leukoplakia
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