Abstract
The purpose of the present study was to review the recurrence and prognostic factors of squamous cell carcinoma (SCC) associated with inverted papilloma (IP). A retrospective chart review was conducted on 21 patients with SCC associated with IP, in the nasal cavity and paranasal sinuses, between March 2007 to March 2017. All patients underwent surgical treatment: Surgery prior to or following adjuvant therapy was performed in 17 patients (81.0%). During a mean follow-up time of 47.4 months (range, 3-123 months), 9 patients (42.9%) experienced local recurrence, and the risk factors of T4 stage and invasive orbital cavity had a significant influence on recurrence. The 1-, 3-, and 5-year overall survival rates were 90.5, 75.4 and 68.5%, and the 1-, 3-, and 5-year disease-specific survival (DSS) rates were 90.5, 80.4 and 80.4%, respectively. The prognosis of patients with stage T4 was not satisfactory compared with those with stage T3 or less, and a positive surgical margin was also significantly associated with poor survival. Overall, SCC associated with IP has a favorable DSS, early diagnosis and complete resection of lesions is required for a good prognosis. Furthermore, aggressive surgical approaches combined with postoperative adjuvant therapy seem to be effective in tumors at stage T4.
Highlights
Inverted papilloma (IP) is a benign epithelial neoplasm in the sinonasal tract, accounting for 0.5‐4.0% of all nasal tumors [1]
The main symptoms of squamous cell carcinoma (SCC) associated with IP presented nasal obstruction and epistaxis; other symptoms included cheek pain, decreased vision and epiphora
The current literature suggests that the incidence of malignancy among patients with IP varies widely and ranges from 2‐27% [6]
Summary
Inverted papilloma (IP) is a benign epithelial neoplasm in the sinonasal tract, accounting for 0.5‐4.0% of all nasal tumors [1]. The incidence of sinonasal SCC associated with IP ranges from 2‐27% in the literature [6]. SCC in IP frequently occurs metachronously, arising in the same site where the IP had previously been resected, or synchronously, diagnosed in the same initial lesion [7]. In a meta‐analysis of 63 case series representing >2,000 patients, Mirza et al [8] reported a 7.1% incidence of synchronous cancer and a 3.6% incidence of asynchronous SCC [8]. Certain symptoms, including nasal obstruction, epitaxis and rhinorrhea are associated with the occurrence of IP and IP‐related SCC [9]; the lack of specificity of these symptoms makes the identification of IP and SCC‐associated IP is often problematic. Complete surgical excision and long‐term follow‐up are recommended treatment options for these patients
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