Korean J Otorhinolaryngol-Head Neck Surg.  2022 May;65(5):268-275. 10.3342/kjorl-hns.2022.00052.

Clinical Characteristics and Treatment Outcome of Squamous Cell Carcinoma Associated With Inverted Papilloma: Comparison With Sinonasal de Novo Squamous Cell Carcinoma

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Korea
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Chungnan National University Sejong Hospital, Sejong, Korea

Abstract

Background and Objectives
Squamous cell carcinoma associated with inverted papilloma (IP+SCC) is different histologically and biologically from sinonasal de novo squamous cell carcinoma (dnSCC). However, few studies have compared the characteristics of patients, behaviors of tumor, and treatment outcome of two different forms of SCC.
Subjects and Method
We retrospectively reviewed the medical records of 30 patients with IP+SCC and 39 patients with dnSCC who had been treated at Chungnam National University Hospital from 1989 to 2018. Demographics, clinicopathological characteristics, treatment modalities and outcome were analyzed.
Results
The mean age, sex ratio, and the proportion of smokers were similar in both groups. On the other hand, the presenting symptoms of each group were somewhat different: nasal symptoms were more frequent in the IP+SCC group, whereas facial symptoms were more frequent in the dnSCC group. Patients with dnSCC showed significantly more advanced T stage, poorer differentiation of cancer cells, and more bone destruction. The upfront method of treatment was surgery in both groups, whereas radiotherapy and chemotherapy were more frequently used as an adjuvant or main treatment in the dnSCC group. Patients with IP+SCC demonstrated better 5-year overall survival and disease-free survival than the dnSCC group. In both groups, patients with the lower T stage had better outcome than those with the higher T stage. The presence of nodal or distant metastasis was an independent, poor prognostic factor for survival regardless of the type of tumor.
Conclusion
Although sinonasal IP+SCC and dnSCC are often considered similar diseases, our findings suggest that IP+SCC may represent a less aggressive form of malignancy than dnSCC.

Keyword

Inverted; Nasal cavity; Papilloma, inverted; Paranasal sinuses; Squamous cell carcinoma
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