Article
Clinical evaluation of staging system for inverted papilloma
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Published: | August 8, 2007 |
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Outline
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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 [Ref. 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.