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

【声带癌前病变手术后复发和癌变的危险因素】

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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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