{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:48:55Z","timestamp":1784018935255,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2015,10,8]],"date-time":"2015-10-08T00:00:00Z","timestamp":1444262400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Recurrent respiratory papillomatosis (RRP) is classically described as a benign neoplasm of the larynx caused by the low-risk human papillomavirus (HPV) viral subtypes. Nevertheless, transformation to dysplasia and invasive carcinoma can occur. We aimed to assess the prevalence of dysplasia and carcinoma-ex-papilloma in both adult-onset and juvenile-onset RRP and identify patient risk factors for this dysplastic transformation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>Ten-year retrospective chart review of a tertiary otolaryngology referral center. Patients with papilloma were identified from a review of a pathology database and clinical records. Patient demographics, pathologic data, and treatment history, including use of cidofovir as an adjunctive therapy for papilloma, were extracted from electronic medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>One hundred fifty-nine RRP patients were identified, 96 adult-onset (AORRP) and 63 juvenile-onset (JORRP) cases. Of this cohort, 139 (87%) had only benign papilloma as a pathologic diagnosis. In the AORRP cohort, 10 patients (10%) were diagnosed with dysplasia or carcinoma in situ in addition to papilloma, and 5 patients (5%) had malignant transformation to invasive carcinoma-ex-papilloma. There was a significantly higher age of disease onset for those with dysplasia or carcinoma versus those without dysplasia or carcinoma (56 vs 45 years old; P = .0005). Of the 63 JORRP patients, there were no cases of dysplasia but 3 (5%) cases of invasive carcinoma-ex-papilloma, all involving pulmonary disease. The JORRP patients with carcinoma-ex-papilloma had a younger average disease onset (2 vs 6 years old; P = .009) and a higher rate of tracheal involvement than those without carcinoma. Gender, smoking history, number of operations, or use of cidofovir showed no association with the development of dysplasia or carcinoma-ex-papillomatosis in either the AORRP or JORRP population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In a large series of RRP, age of disease onset is the strongest predictor of dysplastic transformation in the adult and pediatric population. Carcinoma-ex-papillomatosis was uniformly associated with pulmonary disease in the JORRP population in this series. No other demographic or behavioral factors, including adjunctive therapy with cidofovir, were statistically associated with dysplasia or carcinoma-ex-papilloma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0003489415608196","type":"journal-article","created":{"date-parts":[[2015,10,9]],"date-time":"2015-10-09T20:22:59Z","timestamp":1444422179000},"page":"235-241","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":67,"title":["Risk Factors for Dysplasia in Recurrent Respiratory Papillomatosis in an Adult and Pediatric Population"],"prefix":"10.1177","volume":"125","author":[{"given":"Selmin","family":"Karatayli-Ozgursoy","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"},{"name":"Department of Otolaryngology, Ufuk University, Ankara"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin Avery","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"},{"name":"Departments of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hillel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Akst","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.A.","family":"Best","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,10,8]]},"reference":[{"key":"bibr1-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.05.070"},{"key":"bibr2-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0463.2010.02618.x"},{"key":"bibr3-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414526848"},{"key":"bibr4-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2011.50"},{"key":"bibr5-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1002\/hed.22953"},{"key":"bibr6-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318155a288"},{"key":"bibr7-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099114"},{"key":"bibr8-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1177\/000348940511401105"},{"key":"bibr9-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.06.083"},{"key":"bibr10-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.101"},{"key":"bibr11-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0002263"},{"key":"bibr12-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0113584"},{"key":"bibr13-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1177\/000348940911800704"},{"key":"bibr14-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2013.06.014"},{"key":"bibr15-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810391626"},{"key":"bibr16-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"bibr17-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200309000-00032"},{"key":"bibr18-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1177\/000348940511401104"},{"key":"bibr19-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20785"},{"key":"bibr20-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811700208"},{"key":"bibr21-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3880164"},{"key":"bibr22-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318290427d"},{"key":"bibr23-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1177\/019459988108900533"},{"key":"bibr24-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1080\/00016480701200350"},{"key":"bibr25-0003489415608196","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.179"},{"key":"bibr26-0003489415608196","author":"Karatayli-Ozgursoy S","year":"2015","journal-title":"AOR"}],"container-title":["Annals of Otology, Rhinology &amp; 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