Al-Anbar Medical Journal (Dec 2024)
Recurrent Vocal Fold Leukoplakia: Incidence and Risk Factors
Abstract
Background: Vocal fold leukoplakia (VFL) is a benign lesion of the vocal folds, that if left untreated, possesses the potential to develop into a malignant, high-risk carcinoma of the larynx. There are several risk factors, such as smoking, alcohol consumption, and exposure to chemical irritants affecting the disease severity and recurrence post-surgical intervention.Objective: To examine the demographic and clinical characteristics associated with VFL, to investigate the recurrence of VFL following surgical removal, and to identify prognostic factors that can predict lesion recurrence.Materials and methods: In the current prospective cohort study, 85 adult patients with VFL were recruited. The selected patients underwent a direct laryngoscope, followed by surgical stripping and biopsy sampling for histopathological examination, with subsequent one-year follow-up.Results: Out of 85 patients with VFL, there were 29 patients (34.11%) with recurrence. There were 67 (78.8%) males. The mean age of men was 63.0 ± 6.6 years, compared to 61.1 ± 7.0 years for women. Sixty percent (51) of the cases had a history of smoking. There was no significant impact of sex, age, and smoking on VFL recurrence (P-value > 0.05). However, high-risk histopathological grades and bilateral VFL with involvement of the anterior commissure were significantly correlated with recurrence (P-values of 0.001 and 0.012, respectively). Univariate analysis presented a significant association between high-risk histopathological grade (P-value = 0.001) and bilateral VFL (P-value = 0.012) and recurrence. The high-risk histopathological grade was found to be independently effective in predicting the recurrence of VFL after treatment by utilizing multivariate analysis.Conclusions: VFL had a high recurrence rate. Findings from a high-risk histopathological grade and bilateral VFL with involvement of the anterior commissure can be employed to predict VFL recurrence after surgery. Embracing a healthy and conscious lifestyle by minimizing exposure to risk factors could impede the progression and recurrence of VFL, specifically among individuals who are at higher risk of developing the aggressive form of the disease.
Keywords
