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ICAR SINONASAL TUMORS

TABLE XVI.2 Evidence surrounding sinonasal papilloma association with human papillomavirus (HPV) and malignant conversion.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Rhaet al. 656

Higher rates of recurrence noted in HPV-associated sinonasal IP

HPV association with sinonasal IP recurrence

592 patients with sinonasal IP (14 studies)

2022 2

Systematic

reviewand meta analysis reviewand meta analysis

McCormick et al. 744

2022 2

Systematic

17 studies including 551 patients with benign sinonasal IP and 56 patients with malignant sinonasal IP 794 patients with IP (19 studies)

Association

1. High-risk HPV subtypes associated with increased risk of malignant sinonasal IP 2. HPV-18 shows the greatest effect size Significant association between HPV infection and malignant transformation of IP HPV types 16, 11/16, 18, and 16/18 associated with an increased risk of malignant sinonasal IP Overall rate of malignant transformation for Schneiderian papilloma 9% HPV-18 associated with the malignant transformation of sinonasal IP

between HPV infection and malignant sinonasal IP

Stepp et al. 663

HPV in sinonasal IP and risk of

2021

2

Systematic

reviewand meta analysis

malignant transforma tion to SCC

Dinget al. 745

2021

2

Systematic

900 patients with sinonasal IP (26 studies)

HPV infection of sinonasal IP

reviewand meta analysis

Re et al. 36

2017 2

Systematic review

3177 patients with IP (29 studies)

Rates of

malignant transforma tion

Zhaoet al. 746

2016 2

Systematic

32 studies including 972 patients with

HPV association with transfor mationof sinonasal IP

reviewand meta analysis

benign sinonasal IP and 152 patients with malignant sinonasal IP

HPV infection varies with sinonasal papilloma histology, but no outcomes significant in formal meta-regression for this study

Role of HPV in development and progression of

1956 patients with

Syrjänen and Syrjänen 95

2013 2

Systematic

sinonasal papilloma (76 studies)

reviewand meta analysis

sinonasal papilloma

Viitasalo et al. 652

2023 3

Retrospective cohort

296 patients with sinonasal IP

1. Malignant transforma tion rate of sinonasal IP 2. To determine factors that

1. Two out of 296 patients with sinonasal IP underwent malignant transformation over 8years 2. Attachment-oriented surgery reduces recurrence rates 3. Dysplasia associated with a higher recurrence rate

contribute to recurrence in patients treated for sinonasal IP

(Continues)

subtypes, respectively. 647 Dysplasia plays a preceding role in progression to malignancy in IP and oncocytic papil loma but is rarely seen in exophytic papilloma. 36,643,646 Two major types of dysplasia include keratinizing and

and results in poorer overall outcomes (Table XVI.2). 36,643,646,647,649–651,653,660 Malignant transforma tion is rarely ever seen in exophytic papilloma but can occur 4%–17% and 5%–15% of the time for oncocytic and IP