gms | German Medical Science

78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2007, Munich

Clinical evaluation of staging system for inverted papilloma

Meeting Abstract

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  • corresponding author Thoralf Stange - ENT-Dep., Lukaskrankenhaus, Neuss, Germany
  • Hans-Jürgen Schultz-Coulon - ENT-Dep., Lukaskrankenhaus, Neuss, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno065

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2007/07hno065.shtml

Published: August 8, 2007

© 2007 Stange et al.
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Outline

Text

Introduction: A standard staging system for inverted papillomas of the nose and the paranasal sinuses is preferable for staged therapy regimes – especially against the background of the persistent discussion on first line surgical therapy. In 2000 Krouse [1] proposed a new staging system based on clinical patterns of inverted papillomas. We investigated the applicability of this staging system on the decision making process for a preferential treatment using an endonasal or an extranasasal surgical technique and the effect on the prognosis.

Patients and Methods: We analyzed the outcome of 78 patients undergoing surgery due to a inverted papilloma staged according to Krouse’s classification in relation to the initial tumor stage and treated accordingly by an endonasal or extranasal surgical approach.

Results: We treated 10 tumors staged T1, 35 staged T2 and 31 T3- and 2 T4- tumors. T1- papillomas were operated endonasally as well as the majority of the T2- tumors. An extranasal approach was performed mostly in tumors staged T3. Inverted papilloma recurred in 4 T2-tumors (11,4%) as well as in 10 T3-tumors adding up to an overall recurrence rate of 17,9%. Interestingly, the highest recurrence rate of 40,9% was found in tumors staged T3 that had been operated endonasally.

Conclusion: Our results suggest a valid correlation between Krouse’s staging system of inverted papillomas and the staged related clinical course. Therefore this staging system is useful in predicting clinical outcome and aiding in deciding on a preferable surgical technique. Nevertheless, improvements of the staging system of tumors staged T3 could be beneficial for deciding between an endonasal or extranasal surgical approach.


References

1.
Krouse JH. Development of a staging system for inverted papilloma. Laryngoscope. 2000;110:965-8.