DOI: https://doi.org/10.22263/2312-4156.2024.1.68
N.A. Marozava1, Zh.V. Kaliadzich1, А.P. Mirilenko2
Risk factors for the development of sinonasal inverted papilloma recurrence after surgical treatment
1N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Republic of Belarus
2Belarusian State Agrarian Technical University, Minsk, Republic of Belarus
Vestnik VGMU. 2024;23(1):68-76.
Abstract.
Objectives. To identify factors influencing relapse-free survival of patients with sinonasal inverted papilloma after surgical treatment, to determine risk factors for the development sinonasal inverted papilloma recurrence, to develop a classification scheme for assigning patients to classes of relapse risk and recommendations for observation after surgical treatment.
Material and methods. The study material was based on the data of 51 patients with the diagnosis of sinonasal inverted papilloma, operated with the use of endoscopic surgery and external approaches in various healthcare institutions of the Republic of Belarus from 2010 to 2022 and observed in the N. N. Alexandrov National Cancer Centre.
Results. Relapse-free survival after surgical treatment is lower in patients with two or more concomitant diseases (p=0.033), a history of polyposis rhinosinusitis (p=0.039), and involvement of the maxillary sinus in the tumor process (p=0.030). Independent factors for predicting long-term results of treatment of patients with inverted papilloma are: the number of concomitant diseases, the presence of hypo-/anosmia and the presence of polypous rhinosinusitis. The hazard ratio for patients with 2 or more concomitant diseases was 2.79 (95% CI from 1.32 to 5.90; p=0.007), for patients with hypo-/anosmia – 2.40 (95% CI from 1.05 to 5.50; p=0.037), for patients with polyposis rhinosinusitis – 2.86 (95% CI from 1.32 to 5.90; p=0.008). Based on the developed multivariate model, a classification scheme was obtained that assigned patients to prognostic classes. The hazard ratio for the unfavorable and favorable classes was 3.85 (95% CI from 1.84 to 8.08; p<0.001), median relapse-free survival – 6.3 months (95% CI from 5.5 to 7.0 months) and 97.5 months (95% CI 32.0 – 163.1 months), respectively.
Conclusions. Surgical treatment of sinonasal inverted papilloma using endoscopic surgery and external approaches has shown a high recurrence rate. Independent factors for predicting long-term results of treatment of patients with inverted papilloma are: the number of concomitant diseases, the presence of hypo-/anosmia and the presence of polypous rhinosinusitis.
Keywords: sinonasal inverted papilloma, surgical treatment, recurrence, malignancy, risk factors.
Research work was carried out within the frames of a scientific topic being implemented on the basis of N.N. Alexandrov National Cancer Centre of Belarus “To elaborate and implement algorithm for the treatment of tumors of the nasal cavity and paranasal sinuses with assessment of their malignancy probability taken into account” of the subprogram “Malignant tumors” of the State Research Program (GPNI) “Scientific and technical support of the quality and accessibility of medical services” 2021-2025 (State Registration No. 20221339, 03.08.2022, date for implementation: the 1st quarter of 2022 – the 4th quarter of 2024).
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Information about authors:
N.A. Marozava – oncologist-surgeon of the oncological department of the head and neck tumors, N.N. Alexandrov National Cancer Centre of Belarus, https://orcid.org/0000-0002-1410-8392,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. –Natalya A. Marozava;
Zh.V. Kaliadzich – Doctor of Medical Sciences, head of the laboratory of oncopathology of the head and neck with a group of oncopathology of the central nervous system, N.N. Alexandrov National Cancer Centre of Belarus, https://orcid.org/0000-0002-3759-141X
А.P. Mirilenko – Candidate of Techical Sciences, associate professor of the Chair of Modeling and Design, Belarusian State Agrarian Technical University.
