Our Summary
This study looked at the risk factors for recurrence and development of cancer in patients with pre-cancerous lesions on their vocal cords who had undergone surgery. The researchers looked at the medical records of 148 patients who were treated in a hospital in Chongqing between 2014 and 2017. They found that the overall rate of recurrence within five years was about 15%, and the rate of developing cancer was about 9%.
They analyzed several factors and found that the amount a person smoked, whether they had laryngopharyngeal reflux (a condition where stomach acid flows back into the throat), and the size of the original lesion were all significantly related to both recurrence and development of cancer. Specifically, they found that people who smoked a lot (defined as a smoking index of 600 or more) and those with lesions that covered at least half of a vocal cord were at higher risk.
Interestingly, they also found that people who quit smoking after surgery took longer to develop cancer, suggesting that quitting smoking could delay the onset of cancer.
The researchers concluded that heavy smoking, laryngopharyngeal reflux, and large lesions might increase the risk of recurrence or cancer after surgery for pre-cancerous vocal cord lesions. They recommended further large-scale studies to confirm these findings and help develop better prevention and treatment strategies.
FAQs
- What factors were found to be significantly associated with the recurrence and canceration of premalignant vocal fold lesions after surgery?
- What were identified as independent risk factors for recurrence and canceration following surgery for premalignant vocal fold lesions?
- What was the impact of smoking cessation on the interval of carcinogenesis following surgery for premalignant vocal fold lesions?
Doctor’s Tip
A helpful tip a doctor might tell a patient about vocal cord surgery is to quit smoking and manage laryngopharyngeal reflux, as these factors have been shown to be independent risk factors for recurrence and canceration of premalignant vocal fold lesions. Additionally, it is important to follow postoperative recommendations and attend regular follow-up appointments to monitor for any potential complications or changes in the vocal cords.
Suitable For
The study suggests that patients with premalignant vocal fold lesions who are at risk for recurrence or malignant transformation after surgery are those who have a history of excessive smoking, laryngopharyngeal reflux, and a wide range of lesions. These factors were found to be significantly associated with recurrence and malignant progression in patients undergoing surgical treatment. The study highlights the importance of preoperative evaluation and postoperative follow-up to monitor for potential recurrence or canceration. Further large-scale studies are needed to confirm the impact of these risk factors on postoperative outcomes and to develop better prevention and treatment strategies for patients with premalignant vocal fold lesions.
Timeline
Before vocal cord surgery, a patient may experience symptoms such as hoarseness, voice fatigue, vocal strain, and difficulty speaking. They may also undergo diagnostic tests such as laryngoscopy, imaging studies, and biopsies to determine the extent and nature of the vocal cord lesion.
After vocal cord surgery, the patient will typically experience a period of recovery and rehabilitation. This may include voice rest, speech therapy, and follow-up appointments with the surgeon. The patient may also undergo further tests to monitor for recurrence or canceration of the vocal cord lesion. Lifestyle changes, such as smoking cessation and managing laryngopharyngeal reflux, may be recommended to reduce the risk of complications post-surgery. Follow-up care is crucial to monitor the patient’s vocal cord health and address any potential issues that may arise.
What to Ask Your Doctor
Some questions a patient should ask their doctor about vocal cord surgery include:
- What are the potential risks and complications associated with vocal cord surgery?
- How long is the recovery process expected to take after vocal cord surgery?
- Will I need speech therapy or other rehabilitation after surgery?
- What are the chances of recurrence or canceration of the vocal cord lesions after surgery?
- Are there any specific lifestyle changes or behaviors I should adopt to reduce the risk of recurrence or canceration?
- How often will I need to follow up with you after surgery to monitor for any potential issues?
- Are there any alternative treatment options to surgery that I should consider?
- What is the success rate of this type of surgery for treating vocal cord lesions?
- Will I need any additional tests or imaging studies before or after surgery?
- How experienced are you in performing vocal cord surgeries, and what is your success rate with similar cases?
Reference
Authors: Mo H, Fang H, Luo R, Liao X, Gao L, Song M, Zhou X, Yuan W. Journal: Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 May;37(5):354-359. doi: 10.13201/j.issn.2096-7993.2023.05.007. PMID: 37138397