Inverted papilloma with multifocal attachment is associated with increased recurrence

Area of Science:

• Otorhinolaryngology
• Oncology
• Surgical Pathology

Background:

• Inverted papilloma (IP) is a benign sinonasal tumor known for its high recurrence rate, particularly at the bony attachment site.
• Previous surgical interventions may influence recurrence rates.
• Understanding factors affecting disease control is crucial for effective management.

Purpose of the Study:

• To evaluate the recurrence rates of inverted papilloma based on surgical approach (primary vs. secondary resection).
• To assess the impact of multifocal versus single-focus tumor attachment on disease control.
• To identify predictors of recurrence in sinonasal inverted papilloma.

Main Methods:

• Retrospective review of 535 inverted papilloma resections from 2006 to 2016 at a tertiary-care center.
• Analysis of demographic data, tumor location, attachment sites, and postoperative surveillance.
• Statistical analysis to determine the effect of surgical history and attachment patterns on recurrence.

Main Results:

• A total of 210 patients were analyzed with a mean follow-up of 36.4 months.
• Patients undergoing primary surgery at the institution had a lower recurrence rate (12.4%) compared to those with prior procedures elsewhere (22.3%).
• Multifocal tumor attachment sites significantly increased the risk of recurrence (OR, 3.5; p = 0.002).

Conclusions:

• Primary resection of inverted papilloma is associated with a lower recurrence rate.
• Single-focus tumor attachment is a favorable prognostic factor for disease control.
• These findings emphasize the importance of surgical history and attachment characteristics in managing sinonasal inverted papilloma.