title: Can a panel of clinical, laboratory, and pathological variables pinpoint patients with sinonasal polyposis at higher risk of recurrence after surgery?
abstract: OBJECTIVE
  Despite improved surgical and medical therapies, recurrence remains a significant problem in chronic rhinosinusitis with nasal polyps (CRSwNP), given a recently-reported long-term revision rate of 15%-20%. In this prospective study uni- and multivariate statistical analyses were used to identify clinical, laboratory and conventional pathological parameters for pinpointing CRSwNP patients at higher risk of recurrence after functional endoscopic sinus surgery (FESS).
  
  
  METHODS
  The investigation concerned 179 consecutive patients undergoing FESS for CRSwNP, and 24 of them developed recurrent CRSwNP after FESS.
  
  
  RESULTS
  A univariate statistical model disclosed significant associations between recurrent CRSwNP and serum basophil counts (p=0.03) and percentages (p=0.02). The recurrence rate was higher for patients with eosinophilic-type CRSwNP (p=0.01). In a multivariate logistic model, eosinophilic-type CRSwNP (p=0.025) and serum basophil percentage (statistical trend, p=0.079) retained their independent prognostic significance in relation to CRSwNP recurrence. The discriminatory power of a three-variable panel (age <65 years, serum basophil percentage and eosinophilic type) featured an AUC (ROC) of 0.7028 (an acceptable discriminatory power according to the Hosmer-Lemeshow scale).
  
  
  CONCLUSIONS
  Although our panel achieved an acceptable discriminatory power for CRSwNP recurrence, other parameters (including biomarkers) capable of predicting outcome and orienting postoperative treatment decisions need to be investigated in CRSwNP.
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy. Electronic address: giuseppe.brescia@sanita.padova.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Brescia
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Franchella
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ramacciotti
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Carmelita
authors.initials: C
authors.lastname: Velardita
authors.affiliation: Department of Medicine DIMED, Padova University, Padova, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.affiliation: Department of Medicine DIMED, Padova University, Padova, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Marino
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martini
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000175:diagnosis / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome