{
  "abstract": "Background/Objectives: Inverted sinonasal papilloma (ISP) is a benign tumor with clinically important risks of recurrence and malignant transformation. We investigated factors associated with postoperative recurrence and the clinical significance of human papillomavirus (HPV) DNA detection. Methods: We retrospectively reviewed 104 surgically treated patients with histologically confirmed ISP (2006–2024). Clinical and radiological factors, HPV genotype and viral load, and p16, p53, and Ki-67 expression were evaluated. Recurrence analysis included 86 patients with at least 12 months of total clinical follow-up. Results: Seven patients (8.1%) developed recurrence. Median total clinical follow-up in the recurrence-analysis cohort was 46.5 months. Frontal sinus involvement and attachment-site hyperostosis were associated with recurrence in an exploratory two-variable Cox model, with wide confidence intervals. An additional model incorporating Krouse stage failed to converge. HPV DNA was detected in 21/104 tumors (20.2%): 11 low-risk and 10 high-risk HPV-positive tumors. Viral load was quantifiable in five tumors (0.3–65.0 E6 copies/ng genomic DNA); the remaining 16 were below the quantification limit of 0.25 copies/ng. No significant association between HPV status and recurrence was demonstrated. Two tumors showed p16 overexpression, including one high-risk HPV-positive tumor; no consistent HPV-related immunohistochemical pattern was identified. Conclusions: Frontal sinus involvement and attachment-site hyperostosis were associated with recurrence in this cohort. With only seven events, the findings are exploratory and require validation. A clinically relevant HPV association cannot be excluded, and HPV transcriptional activity cannot be inferred from these data.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Ginowan 901-2720, Okinawa, Japan",
    "Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 1076 Kiyuna, Ginowan 901-2720, Okinawa, Japan",
    "Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus, 1076 Kiyuna, Ginowan 901-2720, Okinawa, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hironori Nakayoshi",
      "orcid": "0009-0004-9093-4188"
    },
    {
      "affs": [
        0
      ],
      "name": "Hitoshi Hirakawa",
      "orcid": "0000-0002-1789-8801"
    },
    {
      "affs": [
        0
      ],
      "name": "Taro Ikegami",
      "orcid": "0000-0001-9041-7712"
    },
    {
      "affs": [
        0
      ],
      "name": "Shogo Takeda",
      "orcid": "0009-0002-6421-7279"
    },
    {
      "affs": [
        0
      ],
      "name": "Tomoyo Higa"
    },
    {
      "affs": [
        0
      ],
      "name": "Masatomo Toyama",
      "orcid": "0000-0002-5978-9910"
    },
    {
      "affs": [
        0
      ],
      "name": "Hidetoshi Kinjyo",
      "orcid": "0009-0003-0092-5812"
    },
    {
      "affs": [
        0
      ],
      "name": "Shunsuke Kondo"
    },
    {
      "affs": [
        0
      ],
      "name": "Norimoto Kise"
    },
    {
      "affs": [
        0
      ],
      "name": "Shinya Agena"
    },
    {
      "affs": [
        1
      ],
      "name": "Naoki Wada"
    },
    {
      "affs": [
        2
      ],
      "name": "Fumi Kawakami"
    },
    {
      "affs": [
        0
      ],
      "name": "Mikio Suzuki",
      "orcid": "0000-0001-7743-8666"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fr4ga6raek8nv.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197619",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666081/?tool=EBI",
  "id": "fr4ga6raek8nv",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13666081",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Head and Neck Surgical Oncology"
    ]
  ],
  "openalex": "W7215067696",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666081/pdf/?tool=EBI",
  "pmcid": "PMC13666081",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/fr4ga6raek8nv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:35Z",
      "native_id": "PMC:PMC13666081",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13666081"
    },
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15197619",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/19/7619"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Head and Neck Surgical Oncology",
      "subfield": "surgery"
    }
  ],
  "title": "Factors Associated with Postoperative Recurrence in Inverted Sinonasal Papilloma: A Single-Center Cohort Study",
  "title_text": "Factors Associated with Postoperative Recurrence in Inverted Sinonasal Papilloma: A Single-Center Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/fr4ga6raek8nv",
  "venue": "Journal of clinical medicine",
  "versions": []
}