Table 5 Clinical risk factors of IP malignant transformation
Study authors | Year | Study design | Level of evidence | Study groups | Intervention | Outcome | Conclusion |
|---|---|---|---|---|---|---|---|
Yu et al. [23] | 2014 | Observational study | C | 356 IP patients, 32 transformed to malignant tumor (21 SCC). | Cases of patients were followed up from 23 to 212 months. | 5-year survival rate is 72.5%, median survival time was 62.2 months. 8.99% of all SNIP cases transformed into SCC, the incidence of malignancy among SNIP cases was 11%. Male to female malignant ratio: 3.6:1 | The main factors affecting prognosis were clinical stage and treatment method. Gender and age of onset are irrelevant to prognosis. Lower staging increase life expectancy. Invasion of orbit and skull predict poor prognosis. |
Kim et al. [7] | 2012 | Observational study | C | 578 pts., 22 (3.8%) SCC. | 578 IP patients from 17 hospitals included for recurrence analysis. Mean follow-up - 41 months. | 15.7% had recurrences. Patients whose IPs involved the frontal sinus or the medial wall of the maxillary sinus had higher recurrence rates. 136 originated from multiple sites. | There was no significant difference in recurrence rates based on stage or surgical approach. Given the rate of delayed recurrence, follow-up of >3 years required. Rcurrences are higher for IP with an original site of frontal sinus or medial wall of MS. |
Sham et al. [24] | 2010 | Observational study | C | 50 pts. vs. 150 matched controls | IP and control group patients were interviewed and data analyzed. | Outdoor and industrial occupations (driver, construction worker) were associated with IP. | Tobacco smoking, drinking alcohol, history of allergic rhinitis, sinusitis, nasal polyp, non-sinonasal papilloma and non-sinonasal malignancy were not significant factors. |
Jardine et al. [25] | 2000 | Observational study | C | 89 pts., 2 SCC | IP patients’ medical histories reviewed. | Mean follow up 2.1 years. | Younger patients were more likely to recur. Smokers tend to have multiple recurrence. P53 is unlikely to be of help in predicting the clinical behavior of IP. Dust exposure is unrelated to recurrent disease. |
Hong, Sung-Lyong [26] | 2013 | Observational study | C | 162 IP patients, 17 SCC (9 synchronous, 3 metachronous) | IP patients; medical histories reviewed. | Recurrence rate is 28.6%, mean period of recurrence was 6.3 months. | Smoking history increased the risk of malignant transformation of SIP (odds ratio: 12.7). |
Il Joon Moon [27] | 2010 | Observational study | C | 132 IP patients, 9 SCC | IP patients; medical histories reviewed. | No association between smoking history and synchronous malignancy was found. | There was a strong association between staging and malignant transformation. Smoking increases recurrence. |