Development and validation of a nomogram based on LASSO regression for predicting early postoperative polyp recurrence in patients with chronic rhinosinusitis with nasal polyps

By
Hanshuang Zhang
Huizhen Zheng
Siqi Wang
Shile Xu
July 14, 2026

Frontiers In Surgery

Objective:

To construct and validate a nomogram model based on commonly used clinical indicators to predict the risk of early postoperative polyp recurrence in patients with CRSwNP.

Approach:

Study Design: A retrospective cohort study was conducted with 374 patients with CRSwNP who underwent endoscopic sinus surgery.
Cohorts: Patients were divided into a training cohort (260 patients) and an internal validation cohort (114 patients), with an external validation cohort of 242 patients from Wenzhou People's Hospital.
Statistical Analysis: Independent risk factors were identified using LASSO regression and multivariate logistic regression, and a nomogram was constructed. Model performance was evaluated using ROC curves, calibration curves, and decision curve analysis.

Key Findings:

Asthma, stage 3 sinusitis, Lund-Mackay score, eosinophils (EOS), and immunoglobulin E (IgE) were identified as independent risk factors for early postoperative recurrence.
The AUCs for the training, internal validation, and external validation cohorts were 0.923, 0.881, and 0.890, respectively.
The model demonstrated good calibration and provided clinical net benefit according to decision curve analysis.

Interpretation:

The nomogram model effectively predicts early postoperative polyp recurrence in CRSwNP patients, aiding in individualized clinical management.

Limitations:

The study is retrospective and may be subject to selection bias.
External validation was limited to one additional hospital, which may affect generalizability.