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Risk Factors for Malignant Transformation in Inverted Sinonasal Papilloma: A Systematic Review and Meta-Analysis
Andrea Ambrosini-Spaltro1, Giulia Querzoli2,3, Anna Caterina Leucci4
1Pathology Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, 47121 Forlì, Italy.
Smoking and Human Papillomavirus (HPV) are significant risk factors for malignant transformation in sinonasal inverted papilloma (IP). Interventions like smoking cessation and HPV vaccination are recommended for affected individuals.
Area of Science:
- Otolaryngology
- Oncology
- Epidemiology
Background:
- Inverted papilloma (IP) is a benign sinonasal tumor with malignant potential.
- Understanding risk factors for malignant transformation is crucial for patient management.
Purpose of the Study:
- To systematically review and meta-analyze risk factors associated with malignant transformation of inverted sinonasal papilloma.
Main Methods:
- A comprehensive search of PubMed and Embase databases was conducted.
- Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS), and evidence quality by GRADE.
- Meta-analyses were performed for smoking, alcohol, and HPV using fixed-effects and random-effects models.
Main Results:
- Twenty-six articles comprising 1271 inverted papilloma cases were analyzed, with an 18.1% carcinoma incidence.
- Smoking (p = 0.002) and HPV (p < 0.001) were identified as significant risk factors.
- Alcohol consumption did not show statistical significance (p = 0.95).
Conclusions:
- Smoking and HPV infection are confirmed risk factors for malignant transformation of inverted sinonasal papilloma.
- Recommendations include smoking cessation and HPV vaccination for individuals with IP.
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