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Clinicopathological predictors of repeated recurrence in sinonasal inverted papilloma

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate association between clinical and pathological findings and repeated recurrence in sinonasal inverted papilloma.

Methods

Retrospective cohort study conducted at a tertiary care teaching hospital included all patients operated for inverted papilloma from January 2010 to December 2019. Patients were categorized as primary and recurrent cases. Based on disease status at follow-up, they were subcategorized into ‘primary with no recurrence’ (PnR), ‘primary with recurrence’ (PwR), ‘recurrent with no further recurrence’ (RnR), and ‘recurrent with further recurrence’ (RwR) groups. Data including demography, clinical, endoscopic and pathological findings were collected and analyzed.

Results

Increased incidence of pale appearance of lesion in RnR group (p = 0.017), polypoidal appearance in primary group (p = 0.002) and fibrous appearance in the recurrent group (p = 0.002) were statistically significant. Predominant epithelium was combined respiratory and squamous epithelium in primary and recurrent groups and also in RnR group (p = 0.019), while it was squamous (p = 0.024) in RwR group. Epithelial hyperplasia was more common in primary and RnR groups. Oncocytic change, cystic dilatation, microabscess and squamous metaplasia were seen more in recurrent and RnR groups. Cytoplasmic glycogenation was more in recurrent and RwR groups. Stroma was predominantly edematous in all the groups.

Conclusions

Patients with recurrence are younger and present earlier than those with primary disease. Fleshy appearance and pink/red colour of tumour, lining epithelium being squamous and cytoplasmic glycogenation could be considered as features predicting recurrence. Negative predictors of recurrence of IP include pale appearance of tumour, combined respiratory and squamous epithelium lining and squamous metaplasia.

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Funding

This study received no funding.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Christian Medical College, Vellore, India

    Rakesh R. Bright, Lalee Varghese, Lisa Mary Cherian, Vedantam Rupa & Regi Kurien

  2. Department of Pathology, Christian Medical College, Vellore, India

    Reshma Kurian, Ramesh Babu Telugu & Meera Thomas

  3. Department of Biostatistics, Christian Medical College, Vellore, India

    Belavendra Antonisamy

Authors
  1. Rakesh R. Bright
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  2. Lalee Varghese
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  3. Reshma Kurian
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  4. Ramesh Babu Telugu
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  5. Lisa Mary Cherian
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  6. Belavendra Antonisamy
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  7. Meera Thomas
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  8. Vedantam Rupa
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  9. Regi Kurien
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Contributions

Research and study design: LV, BA, MT, RK. Data collection and analysis: RRB, RK, TRB, MT. Interpretation and conclusion: RRB, LV, RK, TRB, LMC, BA, MT, VR, RK. Preparation of manuscript: RRB, LV. Review of manuscript: RRB, LV, RK, TRB, LMC, BA, MT, VR, RK. Guide and critical revision: LV, LMC, MT, VR, RK. Administration: LV, BA, MT. Technical support: LV, RK, TRB, LMC, BA, MT, VR, RK.

Corresponding author

Correspondence to Lalee Varghese.

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Conflict of interest

The authors declare that they have no conflict of interest to disclose. The authors alone are responsible for the content and writing of the paper.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional review board approval was obtained prior to the commencement of the study (IRB number: 13249).

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Bright, R.R., Varghese, L., Kurian, R. et al. Clinicopathological predictors of repeated recurrence in sinonasal inverted papilloma. Eur Arch Otorhinolaryngol 280, 1191–1199 (2023). https://doi.org/10.1007/s00405-022-07585-3

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  • DOI: https://doi.org/10.1007/s00405-022-07585-3

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