Factors Associated with Postoperative Recurrence in Inverted Sinonasal Papilloma: A Single-Center Cohort Study
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Ginowan 901-2720, Okinawa, Japan
- 2Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 1076 Kiyuna, Ginowan 901-2720, Okinawa, Japan
- 3Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus, 1076 Kiyuna, Ginowan 901-2720, Okinawa, Japan
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.
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BibTeX
@article{nakayoshi2026factors,
title = {{Factors Associated with Postoperative Recurrence in Inverted Sinonasal Papilloma: A Single-Center Cohort Study}},
author = {Hironori Nakayoshi and Hitoshi Hirakawa and Taro Ikegami and Shogo Takeda and Tomoyo Higa and Masatomo Toyama and Hidetoshi Kinjyo and Shunsuke Kondo and Norimoto Kise and Shinya Agena and Naoki Wada and Fumi Kawakami and Mikio Suzuki},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197619},
url = {https://europepmc.org/article/PMC/PMC13666081},
note = {CC BY},
}
RIS
TY - JOUR
TI - Factors Associated with Postoperative Recurrence in Inverted Sinonasal Papilloma: A Single-Center Cohort Study
AU - Hironori Nakayoshi
AU - Hitoshi Hirakawa
AU - Taro Ikegami
AU - Shogo Takeda
AU - Tomoyo Higa
AU - Masatomo Toyama
AU - Hidetoshi Kinjyo
AU - Shunsuke Kondo
AU - Norimoto Kise
AU - Shinya Agena
AU - Naoki Wada
AU - Fumi Kawakami
AU - Mikio Suzuki
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197619
UR - https://europepmc.org/article/PMC/PMC13666081
AB - 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.
SN - 2077-0383
ER -