Predictors of Remission in Juvenile-Onset Recurrent Respiratory Papillomatosis

OBJECTIVE: To determine factors associated with remission of juvenile-onset recurrent respiratory papillomatosis (JORRP). DESIGN: Longitudinal study. SETTING: Twenty-two tertiary care centers located across the United States. STUDY PARTICIPANTS AND METHODS: The study included 165 patients diagnosed as having JORRP between January 1, 1997, and December 31, 2000. Kaplan-Meier curves and Cox proportional hazards models were used to determine associations between predictors and remission. INTERVENTIONS: Surgical excision and drug therapy. MAIN OUTCOME MEASURES: Remission of JORRP, defined as no surgical procedures for at least 1 year, as associated with age at diagnosis, drug therapy in the first year after diagnosis, number of surgical procedures in the first year after diagnosis, and number of anatomical sites of disease at diagnosis. Demographic factors (sex and race) and Medicaid status were also evaluated. RESULTS: Older age at diagnosis was positively associated with remission of JORRP (hazards ratio for every increase of 1 year in age, 1.13; 95% confidence interval, 1.03-1.23). CONCLUSIONS: Younger children were found to have persistent disease and often underwent an increased number of surgical procedures in the first year after diagnosis of JORRP. Sex and race were not important factors in determining remission.