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The Utilization of the Completeness of Surgery Index in Revision Endoscopic Sinus Surgery Patients on Biologic Therapy for CRSwNP.

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A Novel Risk Stratification Tool for Sinonasal Inverted Papilloma Recurrence: Multi-Institutional Nomogram

Tristan Tham1, Peter Giannaris2, Mostafa Kokabee3

  • 1Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.

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|January 9, 2026
PubMed
Summary

High-risk dysplasia and multifocal attachment predict inverted papilloma recurrence. A new nomogram provides personalized risk estimates for recurrence, guiding surveillance strategies.

Keywords:
dysplasiainverted papillomamulticenter studynomogramsprognosisrecurrencerisk assessmentsinonasal neoplasms

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Area of Science:

  • Otolaryngology
  • Oncology
  • Pathology

Background:

  • Inverted papilloma (IP) is a benign but locally aggressive sinonasal tumor.
  • Recurrence is a significant concern following surgical resection of inverted papilloma.
  • Predictive factors for recurrence require further elucidation to optimize patient management.

Purpose of the Study:

  • To identify independent predictors of inverted papilloma recurrence.
  • To develop a nomogram for estimating individualized recurrence risk.
  • To inform postoperative surveillance strategies based on risk stratification.

Main Methods:

  • Retrospective analysis of a cohort of patients treated for inverted papilloma.
  • Multivariate analysis to identify independent predictors of recurrence.
  • Development and validation of a nomogram for predicting 3-, 6-, and 9-year recurrence risk.

Main Results:

  • High-risk dysplasia and multifocal attachment were identified as independent predictors of inverted papilloma recurrence.
  • The developed nomogram demonstrated good accuracy in predicting individualized recurrence risk.
  • Risk stratification based on nomogram predictions could differentiate patient subgroups with varying recurrence probabilities.

Conclusions:

  • High-risk dysplasia and multifocal attachment are crucial factors influencing inverted papilloma recurrence.
  • The novel nomogram offers a valuable tool for personalized risk assessment and postoperative surveillance planning.
  • Risk-stratified surveillance protocols may enhance the efficiency and effectiveness of monitoring patients after inverted papilloma resection.