Clinical Analysis of Leukoplakia in the Larynx: Long-Term Follow-Up

Heo, Sung Jae; Cho, In Ji; Ahn, Dong Bin; Kim, Jae Hyuk; Park, June Sik; Sohn, Jin Ho

Abstract

BACKGROUND AND OBJECTIVES
Leukoplakia is a clinical term solely designating a white patch or a plaque of the mucosa without considering its histological feature. Leukoplakia ranges microscopically from a hyperplasia to an invasive squamous cell carcinoma. This study attempted to find out the clinical progress and characteristics of leukoplakia in the larynx.
SUBJECTS AND METHOD
Included in the study were 154 patients clinically diagnosed as leukoplakia from 1997 to 2010. We reviewed their medical records retrospectively for age, sex, smoking and drinking history, medical record, histopathologic finding, treatment method, and the follow-up records.
RESULTS
Histopathologic findings of leukoplakia in the larynx showed hyperkeratosis (101 patients), invasive carcinoma (19 patients), dysplasia (14 patients), nodule (9 patients), papillomatosis (4 patients), chronic inflammation (4 patients) and tuberculosis (3 patients). Of the 128 patients, 39 patients who were diagnosed as hyperkeratosis, dysplasia, nodule or chronic inflammation in the larynx had recurrence and received re-biopsy over 2 times. Eight patients of these 39 who had recurrence had progression to invasive carcinoma. The mean interval between diagnosis of leukoplakia and invasive carcinoma was 53 months (ranged 7-114 month). Heavy smoking (more than 20 pack year) and drinking were significantly associated with recurrence or progression to invasive carcinoma. Age, gastroesophageal reflux disease and treatment method were not associated with recurrence.
CONCLUSION
Leukoplakia in the larynx led to various histopathologic diagnoses, high recurrence rate, and progressed to invasive carcinoma even after 5 years. Smoking and drinking should be managed and longterm follow-up is needed.