Surgical management of inverted papilloma; a single-center analysis of 247 patients with long follow-up

J Otolaryngol Head Neck Surg. 2017 Dec 20;46(1):67. doi: 10.1186/s40463-017-0246-7.

Abstract

Background: Our aim was to review our management of inverted papilloma (IP), perform a recurrence analysis, and review the literature.

Methods: A retrospective analysis of 247 patients treated for an IP. Patients were grouped according to surgical approach, tumor presentation (primary, residual and recurrence) and Krouse-stage.

Results: Recurrence was observed in 20.3%, 28.6% and 35.1% (p = 0.017) of the patients who underwent endoscopic, external and combined surgery, respectively. Recurrences occurred more often in residual than primary IP (36.9% vs. 22.3%, p = 0.021). Primary endoscopic surgery had a recurrence rate of 12.5%, which was comparable to the recent literature (11.2%, 161/1433).

Conclusions: The relatively high number of recurrences in this cohort is explained by the long follow-up and previous (incomplete) surgery in 61.5% of the cases. The inferior outcome of residual IP underscores the importance of having a low threshold for preoperative biopsy in unilateral and atypical sinonasal disease.

Keywords: Endoscopic surgery; Follow-up; Inverted papilloma; Recurrence; Retrospective study.

Publication types

  • Review

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Cohort Studies
  • Endoscopy / adverse effects
  • Endoscopy / methods*
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Papilloma, Inverted / pathology
  • Papilloma, Inverted / surgery*
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / surgery*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome