Impact of Dysplasia on Inverted Papilloma Recurrence: A Systematic Review and Meta-Analysis
Abstract
Background: Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor that has demonstrated a propensity to recur. Multiple anatomic and surgical factors have been proposed to influence recurrence; dysplasia has recently emerged as a predictor, yet its prognostic significance remains unclear. Clarifying its role may improve postoperative risk stratification.
Methods: A systematic review and meta-analysis were performed following PRISMA guidelines and registered with PROSPERO (CRD420251140223). PubMed, Embase, Scopus, and Web of Science were queried for studies reporting recurrence outcomes stratified by dysplasia status. Studies with extractable recurrence data for dysplasia and non-dysplasia SNIP were included. Fixed-effects meta-analysis was performed using the inverse variance method to calculate pooled odds ratios (OR) with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 and Cochran's Q statistics.
Results: Thirteen studies comprising 1893 patients were included. Based on reported data, mean age ranged from 48.3 to 58.0 years. The cohort was predominantly male (1172/1720; 68.1%). Of 283 patients with dysplasia, 104 experienced recurrence (36.7%), compared with 302 of 1346 patients without dysplasia (22.4%). Dysplasia was significantly associated with increased recurrence risk (pooled OR 3.42; 95% CI, 2.45-4.78; p 2 = 20.33%). Mean follow-up was 39.8 months. Findings were robust on leave-one-out sensitivity analysis and trim-and-fill…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,893 participants or records.
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