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Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

ABSTRACT: Objective:Reports on sinonasal oncocytic papilloma (SNOP) are scarce. The aim of this retrospective study was to evaluate the clinical features of this rarest form of sinonasal papilloma with special emphasis on the pattern of recurrences and on the potential factors predicting them. Study Design:Retrospective study. Methods:Between the years 1994 and 2016, 20 patients (mean age 66?years; range 30-87) were diagnosed with SNOP at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Hospital charts were reviewed to record various medical and sociodemographic patient characteristics, and the archived histological specimens were re-evaluated. Postoperative follow-up time varied between 26?days and 167?months. Results:Maxillary sinus was the most common (60%) tumor location. None of the tissue samples showed dysplasia. Recurrence rate was 39% and the median time span to the first recurrence was 25?months (range 7-71). Smokers had more often a recurrence than nonsmokers (75% vs. 31%). Patients with perioperative purulent rhinosinusitis during the primary surgery had a higher recurrence rate compared with those without (60% vs. 31%). Tumors located in the sinuses recurred more often than those located in the nasal cavity (45% vs. 29%). However, all these findings remained statistically nonsignificant. None of the cases showed malignant transformation during the follow-up. Conclusion:SNOP has a propensity to recur. History of smoking, purulent rhinosinusitis during the primary surgery, and tumor location in the sinuses outside the nasal cavity seem to contribute to an increased trend in the risk of recurrence. Level of Evidence:4.

SUBMITTER: Lilja M

PROVIDER: S-EPMC6929580 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

Lilja Markus M Viitasalo Sanna S Hytönen Maija M Haapaniemi Aaro A Hagström Jaana J Mäkitie Antti A

Laryngoscope investigative otolaryngology 20190930 6

<h4>Objective</h4>Reports on sinonasal oncocytic papilloma (SNOP) are scarce. The aim of this retrospective study was to evaluate the clinical features of this rarest form of sinonasal papilloma with special emphasis on the pattern of recurrences and on the potential factors predicting them.<h4>Study design</h4>Retrospective study.<h4>Methods</h4>Between the years 1994 and 2016, 20 patients (mean age 66 years; range 30-87) were diagnosed with SNOP at the Department of Otorhinolaryngology-Head an ...[more]

PMID: 31890872

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Project description:ImportanceThe risk factors for the recurrence of sinonasal inverted papilloma are still unclear.ObjectiveTo investigate the potential association between the Krouse classification and the recurrence rates of sinonasal inverted papilloma.Data sourcesThe EMBASE and MEDLINE databases were searched for the period January 1, 1964, through September 30, 2016, using the following search strategy: (paranasal sinuses [Medical Subject Headings (MeSH) terms] OR sinonasal [all fields]) AND (inverted papilloma [MeSH terms] OR (inverted [all fields] AND papilloma [all fields]).Study selectionThe inclusion criteria were (1) studies including sinonasal inverted papilloma only and no other forms of papillomas, such as oncocytic papilloma; (2) minimum follow-up of 1 year after the surgery; and (3) clear report of cases (recurrence) and controls according to the Krouse classification system or deducible from the full-text article. Literature search was performed by 2 reviewers. Of the 625 articles retrieved in the literature, 97 full-text articles were reviewed. Observational cohort studies or randomized controlled trials were included, and the following variables were extracted from full-text articles: authors of the study, publication year, follow-up data, and number of cases (recurrence) and controls (no recurrence) in each of the 4 stages of the Krouse classification system.Data extraction and synthesisThe Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Odds ratios (ORs) and 95% CIs were estimated, and data of included studies were pooled using a random-effects model.Main outcomes and measuresThe main outcome was recurrence after surgical removal of sinonasal inverted papilloma according to each stage of the Krouse classification system.ResultsThirteen studies comprising 1787 patients were analyzed. A significant increased risk of recurrence (51%) was highlighted for Krouse stage T3 disease when compared with stage T2 (pooled OR, 1.51; 95% CI, 1.09-2.09). No significant difference in risk of recurrence was found between Krouse stages T1 and T2 disease (pooled OR, 1.14; 95% CI, 0.63-2.04) or between stages T3 and T4 (pooled OR, 1.27; 95% CI, 0.72-2.26).Conclusions and relevanceInverted papillomas classified as stage T3 according to the Krouse classification system presented a 51% higher likelihood of recurrence. Head and neck surgeons must be aware of this higher likelihood of recurrence when planning and performing surgery for sinonasal inverted papilloma.

Dataset Information

Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

Publications

Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

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