[Risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery].

Hailan Mo, Hongyan Fang, Rui Luo, Xiufu Liao, Leilei Gao, Mei Song, Xia Zhou, Wei Yuan
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Abstract

Objective:To analyze the risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery, and to provide a reasonable basis for preoperative evaluation and postoperative follow-up. Methods:This study retrospective analyzed the relationship between clinicopathological factors and clinical outcome(recurrence, canceration, recurrence-free survival, and canceration-free survival) in 148 patients undergoing surgical treatment in Chongqing General Hospital from 2014 to 2017. Results:The five-year overall recurrence rate was 14.86% and the overall recurrence rate was 8.78%. Univariate analysis showed that smoking index, laryngopharyngeal reflux and lesion range were significantly associated with recurrence(P<0.05), and smoking index and lesion range were significantly associated with canceration(P<0.05). Multivariate logistic regression analysis showed that smoking index ≥600 and laryngopharyngeal reflux were independent risk factors for recurrence(P<0.05), and smoking index ≥600 and lesion range ≥1/2 vocal cord were independent risk factors for canceration(P<0.05). The mean carcinogenesis interval for the postoperative smoking cessation group was significantly longer(P<0.05). Conclusion:Excessive smoking, laryngopharyngeal reflux and a wide range of lesions may be related to postoperative recurrence or malignant progression of precancerous lesions in the vocal cord, and further large-scale multi-center prospective randomized controlled studies are needed to clarify the effects of the above factors on recurrence and malignant changes in the future.

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[声带癌前病变术后复发及癌变的危险因素]。
目的:分析声带癌前病变术后复发、癌变的危险因素,为术前评估及术后随访提供合理依据。方法:回顾性分析2014 - 2017年重庆总医院手术治疗的148例患者的临床病理因素与临床转归(复发、癌变、无复发生存期、无癌生存期)的关系。结果:5年总复发率为14.86%,总复发率为8.78%。单因素分析显示,吸烟指数、咽喉炎反流及病变范围与复发(P(ppppp)显著相关。结论:过度吸烟、咽喉炎反流及病变范围广可能与声带癌前病变术后复发或恶性进展有关。未来需要进一步开展大规模多中心前瞻性随机对照研究,明确上述因素对复发及恶性改变的影响。
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