Skip to main content

Table 5 Clinical risk factors of IP malignant transformation

From: Clinical evidence based review and systematic scientific review in the identification of malignant transformation of inverted papilloma

Study authorsYearStudy designLevel of evidenceStudy groupsInterventionOutcomeConclusion
Yu et al. [23]2014Observational studyC356 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: 3.6:1The 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]2012Observational studyC578 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]2010Observational studyC50 pts. vs. 150 matched controlsIP 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]2000Observational studyC89 pts., 2 SCCIP 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]2013Observational studyC162 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]2010Observational studyC132 IP patients, 9 SCCIP 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.