Steven M Zeitels1. 1. Department of Surgery, Harvard Medical School, and Division of Laryngeal Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA zeitels.steven@mgh.harvard.edu.
Abstract
OBJECTIVE: Conventional wisdom is that the overwhelming majority of glottic cancer patients have a smoking history. However, in recent years observations suggested that an increasing number of glottic cancer patients had never been smokers. Therefore, an investigation was done examining the incidence of having a smoking history in a recent cohort of glottic cancer patients. METHOD: Retrospective review of 100 patients with glottic cancer to determine those reporting never having smoked. RESULTS: Thirty-one of 100 did not have a smoking history. Clinical observations of those cases revealed that the disease morphology tended to be exophytic, papillary, and very vascular, often resembling recurrent respiratory papillomatosis (RRP). Remarkably, 2 of 31 were initially treated elsewhere assuming they had RRP and underwent 5 cidofovir injections. Both presented with advanced cancer, and the disease growth markedly accelerated coincident with the injections. CONCLUSIONS: Observations herein provide new insights that glottic cancer may be an evolving disease in which smoking is less exclusive, not unlike HPV-induced pharynx cancer. Similar to RRP, the angiogenic papillary disease morphology is well suited for voice-preserving angiolytic KTP laser treatment. Given the resemblance of some glottic cancers to RRP, great care should be taken when using cidofovir for papillary glottic neoplasms.
OBJECTIVE: Conventional wisdom is that the overwhelming majority of glottic cancerpatients have a smoking history. However, in recent years observations suggested that an increasing number of glottic cancerpatients had never been smokers. Therefore, an investigation was done examining the incidence of having a smoking history in a recent cohort of glottic cancerpatients. METHOD: Retrospective review of 100 patients with glottic cancer to determine those reporting never having smoked. RESULTS: Thirty-one of 100 did not have a smoking history. Clinical observations of those cases revealed that the disease morphology tended to be exophytic, papillary, and very vascular, often resembling recurrent respiratory papillomatosis (RRP). Remarkably, 2 of 31 were initially treated elsewhere assuming they had RRP and underwent 5 cidofovir injections. Both presented with advanced cancer, and the disease growth markedly accelerated coincident with the injections. CONCLUSIONS: Observations herein provide new insights that glottic cancer may be an evolving disease in which smoking is less exclusive, not unlike HPV-induced pharynx cancer. Similar to RRP, the angiogenic papillary disease morphology is well suited for voice-preserving angiolytic KTP laser treatment. Given the resemblance of some glottic cancers to RRP, great care should be taken when using cidofovir for papillary glottic neoplasms.
Authors: Ian-James Malm; Lisa M Rooper; Justin A Bishop; Selmin Karatayli Ozgursoy; Alexander T Hillel; Lee M Akst; Simon R Best Journal: Am J Otolaryngol Date: 2018-11-22 Impact factor: 1.808
Authors: Hans Edmund Eckel; Ricard Simo; Miquel Quer; Edward Odell; Vinidh Paleri; Jens Peter Klussmann; Marc Remacle; Elisabeth Sjögren; Cesare Piazza Journal: Eur Arch Otorhinolaryngol Date: 2020-10-14 Impact factor: 2.503
Authors: Sebastian Strieth; Benjamin P Ernst; Ina Both; Daniel Hirth; Lara N Pfisterer; Julian Künzel; Katharina Eder Journal: Head Neck Date: 2019-01-31 Impact factor: 3.147