Recurrence of vocal fold leukoplakia after carbon dioxide laser therapy

This work aims to analyze the recurrence of vocal fold leukoplakia after carbon dioxide (CO₂) laser resection. In this retrospective study, all patients undergoing CO₂ laser resection of vocal fold leukoplakia were followed up for at least 2 years. Recurrence was diagnosed as any presence of leukoplakia in the vocal cord subsequent to previous successful complete resection. A total of 326 patients with complete resection of vocal fold leukoplakia and follow-up subsequent surveillance laryngoscopy were studied. The recurrence rate, the recurrence time, and risk factors were evaluated. Of these, 52 (16.0%) patients experienced recurrence with a mean follow-up time of 50.5 ± 15.4 months. The mean time to recurrence was 16.2 ± 14.1 months. Univariate analysis showed that the size of lesion (P < 0.001, Pearson χ ² test; P < 0.001, log-rank test) and the pathological grade (P = 0.025, Pearson χ ² test; P = 0.028, log-rank test) were significantly related to recurrence. The size of lesion was an independent prognostic factor for recurrence using multivariate analysis (P = 0.001, logistic regression; P = 0.001, Cox proportional hazards model). Considering the possible recurrence of vocal fold leukoplakia, long-term follow-up is required after CO₂ laser resection. In conclusion, the size of lesion combined with the pathological grade are important risk factors that predict vocal fold leukoplakia recurrence.