Treatment results in adult-onset recurrent respiratory papillomatosis

To assess remission rate, treatment results, and factors for remission in patients with adult-onset recurrent respiratory papillomatosis (AORRP).

In this retrospective study, the clinical and pathological data of 51 patients with AORRP, treated in University Hospitals between 1972 and 2006 were reviewed. The male-female ratio was 7:3. At diagnosis, the median age was 43 years, and the median retrospective Coltrera-Derkay Staging and Severity score was 6 (range, 2-28). Twenty-one patients (41%) received only surgical treatment. Thirty patients (59%) were treated with surgery and adjuvant intralesional cidofovir.

At the time of analysis in December 2006, 69% of the patients were in remission. Of those, 46% had been treated with adjuvant cidofovir. Of the patients who were not in remission, 87% had been treated with adjuvant cidofovir. This difference was statistically significant (p = 0.005). No significant difference was found between the remission group and the non-remission group for the factors age, gender, smoking habits, alcohol habits, GERD, severity and duration of therapy.

AORRP was curable in most patients after long intensive treatment, with a general remission rate of 69%. Cidofovir was a negative factor for remission (p = 0.005). No other statistically significant factors for remission were found. Although a control group was present, it was not possible to perform a randomized study with comparable groups. A well-designed placebo-controlled, double-blinded, randomized trial to assess the outcomes of adjuvant intralesional cidofovir therapy for RRP would be valuable.