title: [Treatment and prognosis of the carcinoma arising from nasal and sinonasal inverted papilloma: report of 62 cases and systematic review].
abstract: OBJECTIVE
  To analyze the factors affecting prognosis of the carcinoma arising from nasal and sinonasal inverted papilloma.
  
  
  METHODS
  The clinicopathological data of sixty-two patients treated in our hospital from January 1974 to February 2012 were retrospectively analyzed. Of the 62 cases, 10 were at stage I or II, 24 at stage III, and 28 at stage IV. Twenty-six patients were treated with surgery alone, and 36 with surgery combined with radiation therapy. Kaplan-Meier method and log-rank test were used for the survival analysis.
  
  
  RESULTS
  The overall 5-years survival rate was 39.6%. The 5-years survival rate was 67.5% in the stage I or II patients,51.3% in the stage III patients, and 18.3% in the stage IV patients (P<0.05). The 5-years survival rate was 65.7% in patients who had no surgical history, and 29.9% in patients who had surgery (P<0.05). The 5-year survival rate was 17.6% in the group who relapsed after the treatment, and 49.6% in the non-relapsed patients (P<0.05). The 5-year survival rate was 23.4% in the patients who had involvement of cranial base and (or) orbit, and 47.6% in the patients whose cranial base and (or) orbit were clean (P<0.05). Of the patients at the same stage (III-IV), the 5-year survival rate of patients treated with surgery alone was 32.4%, and those treated with combination therapy was 36.2%(P=0.89). The univariate analysis showed that clinical stage, surgical history before malignization, involvement of the cranial base and (or) orbit organs, and post-operative relapse are significantly correlated to prognosis of the patients (P<0.05 for all). Multivariate analysis showed that age, clinical stage, and previous history of surgery were independent factors affecting the prognosis of the patients. Distant metastasis was the major cause of death, mostly lung metastases.
  
  
  CONCLUSIONS
  Age, clinical stage and surgical history are the main factors affecting the prognosis of the patients. The history of recurrence and involvement of cranial base or orbit also play an important role for the prognosis. Distant metastasis is the main cause of death in the patients with carcinoma arising from nasal and sinonasal inverted papilloma.
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Qingzhuang
authors.initials: Q
authors.lastname: Liang
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Email: yuehuangwu@hotmail.com.
authors.forename: Yuehuang
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Dezhi
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Zhengang
authors.initials: Z
authors.lastname: Xu
mesh_terms: D002277:Carcinoma / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms; D006801:Humans; D008175:Lung Neoplasms; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D018308:Papilloma, Inverted / Q000175:diagnosis* / Q000628:therapy; D030361:Papillomavirus Infections; D011379:Prognosis; D012189:Retrospective Studies; D019291:Skull Base; D015996:Survival Rate