Aggressive elimination of precancerous lesions of the vocal cords to avoid risk of cancer.

INTRODUCTION Several studies show that early histological classification and excision of precancerous lesions of the vocal cords reduces the risk of cancer development. National Danish guidelines have not been established. The purpose of this study was to describe a Danish series of patients with precancerous lesions of the vocal cords and to estimate the risk of malignant transformation. MATERIAL AND METHODS This was a retrospective cohort study, including a total of 101 patients with histologically verified precancerous lesions of the vocal cords who were treated from 1997 to 2007 at Odense University Hospital (OUH). RESULTS Among the 101 patients, 18 (18%) were diagnosed with mild dysplasia, 16 (16%) with moderate dysplasia, 35 (35%) with severe dysplasia and 32 (32%) with carcinoma in situ (CIS) at the initial examination at OUH. Fifteen patients (15%), all males, developed invasive cancer. Among these, one patient was initially diagnosed with mild dysplasia, one with moderate dysplasia, seven with severe dysplasia and six with CIS. In 11 of the 15 patients (73%), cancer occurred within one year from the time of diagnosis of the precancerous lesion, whereas four cancers occurred years later. CONCLUSION The malignant transformation rate is comparable with other recent series. A strategy with elimination of all visible pathology is preferable. FUNDING not relevant. TRIAL REGISTRATION not relevant.