The Laryngoscope · 2025
Effect of Serial Intralesional Steroid Injections on Risk of Recurrence in Idiopathic Subglottic Stenosis.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Ying Shengjie, Zeng Peter Y F, Fung Kevin, Khan Halema, Cecchini Matthew J, MacInnis Patrick, Anderson Jennifer, Karimi Amir H, Al Jawhri MohdWessam, Pan Harrison, Le Nhi, Joris Krista, Mymryk Joe S, Dumeaux Vanessa, Barrett John W, Nichols Anthony C, Lin R Jun, Canadian Airways Research Group of the Canadian Society of Otolaryngology Collaborative Research Initiative
Аннотация
BACKGROUND: Serial intralesional steroid injections (ILSIs) have been suggested to be an effective adjunct treatment for idiopathic subglottic stenosis (iSGS) by maintaining airway patency and extending inter-surgical intervals. However, evidence for the effectiveness of serial ILSIs remains inconclusive. The current study aimed to assess whether ILSIs reduce the risk of subsequent surgical dilation (i.e., recurrence) in a cohort of patients with iSGS.
METHODS: Prospectively collected clinical data for 75 female iSGS patients with 1-4 years of follow-up were analyzed. To assess the effect of ILSI use on the risk of recurrence, we assessed both the time-to-first recurrence using a standard Cox proportional hazards model and all recurrences per patient using a recurrent-events model. Overall, there were 36 patients who had received ILSIs at any point in the follow-up period and 39 patients who had not.
RESULTS: ILSI use was associated with a significantly reduced risk of recurrence in both time-to-first event (hazard ratio (HR) = 0.20, 95% confidence interval (CI) 0.08-0.49) and recurrent events (HR = 0.44, 95% CI 0.26-0.75) multivariate Cox proportional hazard models, along with older age at diagnosis and longer time since diagnosis (all p < 0.05). In the time-to-first event analysis, the median time to recurrence among those who had received ILSIs was 2.5 years compared to 1.4 years among those who had not. The number needed to treat with ILSIs to avoid one recurrence by 2 years follow-up was two.
CONCLUSION: Serial ILSIs were associated with reduced risk of recurrence, along with older age at diagnosis and longer time since diagnosis.
LEVEL OF EVIDENCE: 3 (non-randomized controlled cohort/follow-up study).
METHODS: Prospectively collected clinical data for 75 female iSGS patients with 1-4 years of follow-up were analyzed. To assess the effect of ILSI use on the risk of recurrence, we assessed both the time-to-first recurrence using a standard Cox proportional hazards model and all recurrences per patient using a recurrent-events model. Overall, there were 36 patients who had received ILSIs at any point in the follow-up period and 39 patients who had not.
RESULTS: ILSI use was associated with a significantly reduced risk of recurrence in both time-to-first event (hazard ratio (HR) = 0.20, 95% confidence interval (CI) 0.08-0.49) and recurrent events (HR = 0.44, 95% CI 0.26-0.75) multivariate Cox proportional hazard models, along with older age at diagnosis and longer time since diagnosis (all p < 0.05). In the time-to-first event analysis, the median time to recurrence among those who had received ILSIs was 2.5 years compared to 1.4 years among those who had not. The number needed to treat with ILSIs to avoid one recurrence by 2 years follow-up was two.
CONCLUSION: Serial ILSIs were associated with reduced risk of recurrence, along with older age at diagnosis and longer time since diagnosis.
LEVEL OF EVIDENCE: 3 (non-randomized controlled cohort/follow-up study).