Characterization of laryngopharyngeal reflux in patients with premalignant or early carcinomas of the larynx

BACKGROUND An association between laryngopharyngeal reflux (LPR) and laryngeal carcinoma has been suggested, but remains unproven. The current pilot study was performed to determine the incidence of LPR among patients with early laryngeal carcinomas or dysplasia and to examine the associations between levels of LPR and histologic stage, smoking status, the symptom of heartburn, and body position during reflux episodes. METHODS Behavioral and 24 hour pH monitoring data were prospectively acquired and analyzed for 40 previously untreated adults with dysplasia, T1or T2 laryngeal carcinomas. RESULTS Eighty‐five percent of patients had LPR. No significant association was shown between the level of LPR and histologic stage or smoking status. Heartburn did not predict LPR. The incidence of LPR in the upright body position was 91%, compared with 9% in the supine position, among patients with LPR. CONCLUSIONS When compared to available normative data, the current findings show a high incidence of LPR in patients with premalignant and early laryngeal cancer. These findings highlight the need for a matched‐control study evaluating LPR as a potential predisposing factor for laryngeal carcinoma. Cancer 2003;97:1010–4. © 2003 American Cancer Society. DOI 10.1002/cncr.11158 An association between laryngeal carcinoma and laryngopharyngeal reflux (LPR) has been suggested but not proven. Twenty‐four hour pH monitoring revealed an 85% incidence of LPR in a cohort of patients with premalignant and early carcinomatous lesions of the larynx. LPR did not correlate with histologic classification, smoking status, or symptoms of heartburn, and occurred most commonly in the upright body position. A matched‐control study is needed as the next step in evaluating LPR as a potential predisposing factor for laryngeal carcinoma.