LARYNGEAL DYSPLASIA - EPIDEMIOLOGY AND TREATMENT OUTCOME

retrospective analysis was undertaken of 65 patients with long-term fo llow-up for laryngeal squamous dysplasia. Based on the degree of dyspl asia demonstrated on initial biopsy, 0 of 6 patients showing hyperkera tosis without dysplasia, 3 of 26 patients (12%) showing mild dysplasia , 5 of 15 patients (33%) showing moderate dysplasia, 4 of 9 patients ( 44%) showing severe dysplasia, and 1 of 9 patients (11%) showing carci noma in situ eventually progressed to invasive carcinoma. An analysis was made of the impact of various treatment modalities in 33 patients demonstrating moderate dysplasia, severe dysplasia, or carcinoma in si tu. Invasive carcinoma developed in 10 of 21 patients (48%) treated en doscopically and 0 of 12 patients treated by more aggressive therapy, including external beam radiotherapy, partial laryngectomy, or total l aryngectomy. Of the patients in the endoscopic therapy group who devel oped invasive carcinoma, all were salvaged successfully. The overall r ate of laryngeal preservation was 15 of 21 patients (71%) in the endos copic treatment group and 11 of 12 patients (92%) in the aggressive tr eatment group. that there is a moderately high rate of progression to invasive carcinoma in patients undergoing repeated endoscopic therapy for intraepithelial neoplasms of the larynx. However, with close, long -term follow-up, patients undergoing endoscopic therapy have an overal l outcome similar to that in patients treated with partial laryngectom y or radiotherapy prior to developing invasive disease.