Laryngeal Biopsies: Are We Doing More? A Decade of Results

Abstract

Objective: Laryngeal biopsies are frequently performed in current ENT head and neck practice. Over the past decade, we have observed an escalating trend in the biopsies performed. The aim of this study is to quantify the rate of laryngeal biopsies and to record the indications from 2001-2010 in North Glasgow, Scotland.

Method: A retrospective analysis of laryngeal biopsies performed in North Glasgow, Scotland, between 2001 and 2010 was carried out through the North Glasgow Pathology Database. Data pertaining to the site and histopathological diagnoses were collected and analyzed for each biopsy incident. The diagnoses of the biopsies are categorized under 8 classifications.

Results: From 2001 to 2010, 3902 laryngeal biopsy episodes were identified with 888 (23%) diagnosed as squamous cell carcinoma (SCC), 705 (18%) as dysplasia, 831 (21%) as no tumor, and the remaining 1478 (38%) as benign pathology. Between 2001 and 2003, approximately 300 biopsies were performed annually. From 2004-2010, over 400 biopsies were performed annually (χ² = 115.0, P < .01). Approximately 120 benign biopsy episodes and 90 SCC diagnostic biopsy episodes occurred annually. From 2004, there has been significant increase in dysplasia biopsy episodes and those for surveillance of SCC. The latter has increased 2- to 3-fold and has remained constant (χ² = 71.78, P < .01).

Conclusion: There has been an increase in biopsy episodes after 2004 with the incidence of SCC remaining relatively constant. It is hypothesized that organ preservation strategies, endoscopic resection in early laryngeal cancer, and chemoradiotherapy in advanced head and neck cancer are responsible for the increase in overall biopsy episodes from 2004.