Laryngeal dysplasia: relationship between anterior commissure involvement and progression to invasive cancer

Objectives Laryngeal dysplasia is a pre-cancerous lesion within the larynx. This study aims to identify factors influencing progression to cancer by analysing long-term follow-up data. Methods Data from 221 patients diagnosed between 2005 and 2017 were reviewed retrospectively. Patient demographics, treatment strategies and follow-up results were compared. Results Progression to cancer occurred in 26 patients (11.7 per cent). A significant association was found between cancer progression and initial biopsies obtained from the anterior commissure (34.6 per cent in progressing cases vs. 6.2 per cent in non-progressing; p < 0.001). Carcinoma in situ cases showed a higher progression rate (21.7%) compared to mild dysplasia (3.4 per cent) ( p = 0.007). The group with cancer progression also had higher rates of other cancers (15.4 per cent vs. 2.1 per cent; p = 0.008), including lung cancer (11.5 per cent vs. 0 per cent; p = 0.001). Conclusion The study determined an 11.7 per cent progression rate of laryngeal dysplasia to cancer. Lesions involving the anterior commissure carried an approximately 8.1-fold increased risk of progression.