A Clinical Retrospective Study On The Postoperative Prognosis Of Vocal Cord Leukoplakia

Objective:To investigate the clinical factors affecting the postoperative prognosis of vocal cord leukoplakia.Methods:A total of 416 cases of the first time surgical treatment in vocal cord leukoplakia from January 1998 to December 2013 were retrospectively analyzed,calculated the ratios of recurrence and malignant transformation on 1-,3-,and 5-year after surgical operation.Single factor analysis using Log-rank method was first performed to examine the associations between leukopakia recurrence or malignant transformation and clinic factors,including sex,age,course of disease,education,smoking,alcohol consumption,size of leukoplakia,leukoplakia involving anterior commissure,surgical method and histopathological classification.Then the association of these selected factors with recurrence and malignant transformation in vocal cord leukoplakia were evaluated using COX regression analysis.Results:107 cases of all 416 patients with vocal cord leukoplakia were the recurrence and 43 cases developed into larynx cancer after surgical operation.The 1-,3-and 5-year ratios of recurrence were 9.4%,19.9%and 24.3%respectively;the 1-,3-and 5-year ratios of malignant transformation were 1.9%,6.3%and 9.3%respectively.Age,course of disease,size of leukoplakia,leukoplakia involving anterior commissure,surgical method and histopathological classification were chosen as risk factors incorporated into recurrence multiple COX regression model.The multiple COX regression showed that the size,involving anterior commissure,surgical method and histopathological classification were the risks of recurrence in vocal cord leukoplakia.The risk of postoperative recurrence in large size group was 1.73 times as small size group.The risk of postoperative recurrence in involving anterior commissure group was 2.19 times as not involving anterior commissure group.The risk of recurrence after CO2 laser surgery was 0.34 times as microscopic mucosal exfoliation.The risk of postoperative recurrence in moderate dysplasia group was 2.58 times as squamous cell hyperplasia group,and the risk of postoperative recurrence in severe dysplasia group was 5.80 times as squamous cell hyperplasia group.The risk of postoperative malignant transformation in involving anterior commissure group was 3.05 times as not involving anterior commissure group.The risk of postoperative malignant transformation in mide dysplasia group was 3.51 times as squamous cell hyperplasia group,the risk of postoperative malignant transformation in moderate dysplasia group was 16.92 times as squamous cell hyperplasia group,and the risk of postoperative malignant transformation in severe dysplasia group was 44.24 times as squamous cell hyperplasia group.Conclusion:It came to the conclusion that the size of leukoplakia,leukoplakia involving anterior commissure,surgical method and histopathological classification were the predictive factors for the risk of postoperative recurrence in vocal cord leukoplakia,and leukoplakia involving anterior commissure and histopathological classification were the predictive factors for the risk of malignant transformation.