Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center

Background and Objectives Sinonasal inverted papilloma (IP) is a benign tumor with a locally aggressive nature and a propensity to recur. Many risk factors for recurrence have been reported, but they are still controversial. The aim of this study was to comprehensively assess the demographic data, c...

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Main Authors: Soo Kyoung Park, Geonho Lee, Min Su Kim, Yong Min Kim, Ki-Sang Rha
Format: Article
Language:English
Published: Korean Rhinologic Society 2020-11-01
Series:Journal of Rhinology
Subjects:
Online Access:http://www.j-rhinology.org/upload/pdf/jr-2020-00309.pdf
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author Soo Kyoung Park
Geonho Lee
Min Su Kim
Yong Min Kim
Ki-Sang Rha
author_facet Soo Kyoung Park
Geonho Lee
Min Su Kim
Yong Min Kim
Ki-Sang Rha
author_sort Soo Kyoung Park
collection DOAJ
description Background and Objectives Sinonasal inverted papilloma (IP) is a benign tumor with a locally aggressive nature and a propensity to recur. Many risk factors for recurrence have been reported, but they are still controversial. The aim of this study was to comprehensively assess the demographic data, clinical features, and potential risk factors for recurrence of IP. Subjects and Method This work is a retrospective review of 382 patients diagnosed with and treated for sinonasal inverted papilloma between 1986 and 2017 at a single tertiary medical center. Demographic data, presence of associated malignancy, information about previous surgeries, tumor location, Krouse stage, surgical approach, follow-up duration, and data on recurrence were obtained. Results In our study, 31 of 382 cases (8.1%) were associated with malignancy. Mean age was significantly higher in patients with associated malignancy compared to the benign IP group. Of the 351 benign cases, 263 (74.9%) were primary, and 88 (25.1%) were revision cases (residual or recurrent disease). Although the proportion of patients with high Krouse stage or multifocal involvement was high in the revision cases, there was no significant difference in recurrence rate. The 226 patients with a minimum follow-up of 1 year were included for recurrence analysis. Recurrence rate was significantly higher in the conventional surgery group (17.4%) compared to that of the endoscopic and combined surgery groups (8.1% and 3.6%, respectively). Also, the recurrence group showed significantly larger proportion of patients with high Krouse stage and multifocal involvement. Conclusion Risk factors for recurrence of IP found in this study are comparable to those previously published. Generally, the factors associated with recurrence of IP were prior surgery, clinical stage, involved site, and surgical approach. Therefore, surgeons should always consider these risk factors to reduce the chance of recurrence.
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spelling doaj.art-46108aa93fdf44d6bc6e44f5b2052eee2022-12-21T22:51:37ZengKorean Rhinologic SocietyJournal of Rhinology1229-14982384-43612020-11-0127210210710.18787/jr.2020.00309686Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical CenterSoo Kyoung Park0Geonho Lee1Min Su Kim2Yong Min Kim3Ki-Sang Rha4Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, KoreaDepartment of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, KoreaDepartment of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, KoreaDepartment of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, KoreaDepartment of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, KoreaBackground and Objectives Sinonasal inverted papilloma (IP) is a benign tumor with a locally aggressive nature and a propensity to recur. Many risk factors for recurrence have been reported, but they are still controversial. The aim of this study was to comprehensively assess the demographic data, clinical features, and potential risk factors for recurrence of IP. Subjects and Method This work is a retrospective review of 382 patients diagnosed with and treated for sinonasal inverted papilloma between 1986 and 2017 at a single tertiary medical center. Demographic data, presence of associated malignancy, information about previous surgeries, tumor location, Krouse stage, surgical approach, follow-up duration, and data on recurrence were obtained. Results In our study, 31 of 382 cases (8.1%) were associated with malignancy. Mean age was significantly higher in patients with associated malignancy compared to the benign IP group. Of the 351 benign cases, 263 (74.9%) were primary, and 88 (25.1%) were revision cases (residual or recurrent disease). Although the proportion of patients with high Krouse stage or multifocal involvement was high in the revision cases, there was no significant difference in recurrence rate. The 226 patients with a minimum follow-up of 1 year were included for recurrence analysis. Recurrence rate was significantly higher in the conventional surgery group (17.4%) compared to that of the endoscopic and combined surgery groups (8.1% and 3.6%, respectively). Also, the recurrence group showed significantly larger proportion of patients with high Krouse stage and multifocal involvement. Conclusion Risk factors for recurrence of IP found in this study are comparable to those previously published. Generally, the factors associated with recurrence of IP were prior surgery, clinical stage, involved site, and surgical approach. Therefore, surgeons should always consider these risk factors to reduce the chance of recurrence.http://www.j-rhinology.org/upload/pdf/jr-2020-00309.pdfpapillomainvertedparanasal sinusesstagingrecurrence
spellingShingle Soo Kyoung Park
Geonho Lee
Min Su Kim
Yong Min Kim
Ki-Sang Rha
Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center
Journal of Rhinology
papilloma
inverted
paranasal sinuses
staging
recurrence
title Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center
title_full Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center
title_fullStr Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center
title_full_unstemmed Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center
title_short Clinical Analysis of 382 Sinonasal Inverted Papilloma Cases Treated at A Single Tertiary Medical Center
title_sort clinical analysis of 382 sinonasal inverted papilloma cases treated at a single tertiary medical center
topic papilloma
inverted
paranasal sinuses
staging
recurrence
url http://www.j-rhinology.org/upload/pdf/jr-2020-00309.pdf
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