European Laryngological Society position paper on laryngeal dysplasia Part II : diagnosis, treatment, and follow-up
Eckel, Hans Edmund (Klagenfurt General Hospital)
Simo, Ricard (Guy's and St Thomas' NHS Foundation Trust (Regne Unit))
Quer, Miquel (Institut d'Investigació Biomèdica Sant Pau)
Odell, Edward (King's College Hospital NHS Foundation Trust)
Paleri, Vinidh (Royal Marsden Hospital (Regne Unit))
Klussmann, Jens Peter (University of Cologne)
Remacle, Marc (Department of Otorhinolaryngology, Head and Neck Surgery, CH Luxembourg, Luxembourg, Belgium)
Sjögren, Elisabeth (Leiden University Medical Center)
Piazza, Cesare (ASST Spedali Civili of Brescia, University of Brescia)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	To give an overview of the current knowledge regarding the diagnosis, treatment, and follow-up of laryngeal dysplasia (LD) and to highlight the contributions of recent literature. The diagnosis of LD largely relies on endoscopic procedures and on histopathology. Diagnostic efficiency of endoscopy may be improved using videolaryngostroboscopy (VLS) and bioendoscopic tools such as Narrow Band Imaging (NBI) or Storz Professional Image Enhancement System (SPIES). Current histological classifications are not powerful enough to clearly predict the risk to carcinoma evolution and technical issues such as sampling error, variation in epithelial thickness and inflammation hamper pathological examination. Almost all dysplasia grading systems are effective in different ways. The 2017 World Health Organization (WHO) system should prove to be an improvement as it is slightly more reproducible and easier for the non-specialist pathologist to apply. To optimize treatment decisions, surgeons should know how their pathologist grades samples and preferably audit their transformation rates locally. Whether carcinoma in situ should be used as part of such classification remains contentious and pathologists should agree with their clinicians whether they find this additional grade useful in treatment decisions. Recently, different studies have defined the possible utility of different biomarkers in risk classification. The main treatment modality for LD is represented by transoral laser microsurgery. Radiotherapy may be indicated in specific circumstances such as multiple recurrence or wide-field lesions. Medical treatment currently does not have a significant role in the management of LD. Follow-up for patients treated with LD is a fundamental part of their care and investigations may be supported by the same techniques used during diagnosis (VLS and NBI/SPIES).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article de revisió ; Article ; Versió publicada
Subject:	Carcinoma in situ ; Dysplasia ; Laryngeal intraepithelial neoplasia ; Laryngeal carcinoma ; Laser surgery ; Radiotherapy
Published in:	European archives of oto-rhino-laryngology, Vol. 278 (october 2020) , p. 1723-1732, ISSN 1434-4726

Part I de l'article: https://ddd.uab.cat/record/241080
DOI: 10.1007/s00405-020-06406-9
PMID: 33058010

10 p, 505.5 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Published articles