Current Practice, Safety and Efficacy of Interventions for Recurrent Respiratory Papillomatosis: Evidence From a UK Registry.

Autor: Donne AJ; Alder Hey Children's NHS Foundation Trust, Liverpool, UK., Keltie K; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.; Translational and Clinical Research Institute, Faculty of Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK., Burn J; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK., Belilios E; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK., Powell S; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.; Population Health Sciences Institute, Faculty of Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK., Cognigni P; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK., Nixon IJ; Department of Otolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, UK., Bateman N; Royal Manchester Children's Hospital, Manchester, UK., Kubba H; Royal Hospital for Children, Glasgow, UK., Judd O; University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK., Sims A; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.; Translational and Clinical Research Institute, Faculty of Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Jazyk: angličtina
Zdroj: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery [Clin Otolaryngol] 2024 Oct 24. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1111/coa.14245
Abstrakt: Objectives: To determine the current practice, safety and efficacy of interventions used in the management of recurrent respiratory papillomatosis (RRP) in the UK NHS.
Design: Prospective registry (recruitment between 1st April 2018 and 31st August 2022, retrospective data from 1st January 2015 permitted with consent). Sub-group data-linked to Hospital Episode Statistics for additional follow-up (until 31st July 2022).
Setting: UK NHS hospitals treating RRP patients.
Participants: Children and adults diagnosed with RRP and managed in an NHS hospital.
Main Outcome Measures: Disease severity (Derkay, voice handicap and GRBAS scores), management (type and frequency of surgical and adjuvant intervention) and complications (cancer, death).
Results: Three hundred and thirty patients were entered into the registry; 304 (including 65 children) were eligible for analysis. Children had more severe disease than adults (median Derkay score 10 vs. 5). Microdebrider was the most common surgical intervention, particularly in children (86% of children, 49% of adults). Additionally, lasers (CO 2 , KTP and pulsed dye) were used in 34% of adults. Gardasil was the most common adjuvant therapy (21 children, 23 adults). Procedural complications were rare (10.8% children, 5.9% adults). Five patients developed laryngeal malignancy; there were six deaths during follow-up period.
Conclusions: This is the largest UK RRP study to date. RRP is more aggressive in children than adults, and treatment choice differs between age groups. Overall, management was safe with minimal complications reported, and generally effective in maintaining a safe airway. Standardised reporting is required to objectively monitor disease progression and safety over time.
Trial Registration: NCT03465280, ISRCTN36100560.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: