The Prognostic Value of Adding Narrow‐Band Imaging in Transoral Laser Microsurgery for Early Glottic Cancer: A Review

Campo, Flaminia; D’Aguanno, Vittorio; Greco, Antonio; Ralli, Massimo; Vincentiis, Marco de

doi:10.1002/lsm.23142

Cited by 19 publications

(13 citation statements)

References 31 publications

(53 reference statements)

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“…NBI technique has been recently confirmed to improve the accuracy of intraoperative neoplastic superficial spreading evaluation and accuracy of the tumour resection during TLM in early glottic cancer [20]. Based on our own experience and the results of the study, we proved that the NBI is also a helpful tool in decision-making regarding follow-up in cases with positive margins after TOLM.…”

Section: Plos Onementioning

confidence: 60%

The usefulness of the narrow band imaging (NBI) in decision-making process regarding second look procedure (SL) in laryngeal cancer follow-up after transoral laser microsurgery

et al. 2020

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Background The prognostic value of positive surgical margins after transoral laser microsurgery (TOLM) is still under debate. In case of positive superficial margins, some experts recommend a second-look surgery (SL) and some recommend wait and watch approach with close observation. Narrow band imaging (NBI) is an advanced imaging system used to enhance visualization of mucosal vascular pattern. In laryngology, NBI is used to improve the detection of premalignant, dysplastic and malignant lesions. Aim To assess the usefulness of NBI imaging in guiding clinical decision making regarding follow-up plan and SL after TOLM. Materials and methods A prospective cohort of 127 patients was divided into three groups based on the histology results and NBI vascular pattern of the mucosa. Group A (24/127, 18.90%) consisted of patients with suspicious vascular pattern in NBI or/and with positive deep margin. Group B (52/127, 40.94%) consisted of patients with positive or uncertain superficial margins and non-suspicious vascular pattern in NBI. Group C (51/127, 40.15%) had non-suspicious vascular NBI pattern and all negative margins. Results After the first TOLM procedure, 9/24 (37.5%) patients had positive deep margins, 1/24 (4.2%) had uncertain deep margin and 1/24 patient (4.2%) had both positive deep margin

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Section: Plos Onementioning

confidence: 60%

The usefulness of the narrow band imaging (NBI) in decision-making process regarding second look procedure (SL) in laryngeal cancer follow-up after transoral laser microsurgery

et al. 2020

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“…One of the most implemented techniques in clinical practice is narrow-band imaging (NBI); a significant reduction of positive superficial margins was found in patients treated with intraoperative use of NBI (52%) compared to patients treated without intraoperative NBI (28.6%; P < .05). 72…”

Section: Discussionmentioning

confidence: 99%

Laser Microsurgery Versus Radiotherapy Versus Open Partial Laryngectomy for T2 Laryngeal Carcinoma: A Systematic Review of Oncological Outcomes

et al. 2020

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Introduction: The aim of the current systematic review is to update the pooled survival outcome of patients with T2 glottic carcinoma treated with either laser surgery (CO2 transoral laser microsurgery [CO2 TOLMS]), radiotherapy (RT), or open partial laryngectomy (OPL). Methods: A systematic search was performed using the MEDLINE database, Scopus, and Google scholar. The inclusion criteria were studies of patients with T2N0 glottic tumor, treated with either primary CO2 TOLMS, definitive curative RT, or primary OPL, and with reported oncological outcome at 5 years calculated with a Kaplan-Meier or Cox regression method. Results: The results of the current review show that local control (LC) is higher with OPL 94.4%, while there are no differences in LC at 5-year posttreatment for patients treated with RT, compared to those treated with CO2 TOLMS (respectively, 75.6% and 75.4%). Primary treatment with OPL and CO2 TOLMS results in higher laryngeal preservation than primary treatment with RT (respectively 95.8%, 86.9%, and 82.4%). Conclusion: First-line treatment with OPL and CO2 TOLMS should be encouraged in selected T2 patients, because it results in higher laryngeal preservation and similar LC compared to primary treatment with RT. The involvement of the anterior commissure in the craniocaudal plane and T2b impaired vocal cord mobility have a poorer prognosis and LC compared to patients with T2a tumors for both CO2 TOLMS and RT.

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“…13,18 In fact, NBI is an endoscopic system that enables a better evaluation of the microvascular pattern in cases of preneoplastic and neoplastic lesions of the mucosa that cannot be examined with white-light endoscopy. 31 So, NBI enables the detection of the early recurrence of the tumor and its superficial extension, but cannot evaluate the depth of the infiltration.…”

Section: Management Policies According To the Status Of The Resection Marginsmentioning

confidence: 99%

Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

Verro

Greco

Chianetta

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Transoral laser microsurgery (TLM) is the treatment of choice for Tis-T2 squamous cell glottic carcinomas due to its advantages compared with open surgery and radiotherapy. However, the CO2 laser beam causes changes and damage on the specimens, making the histological assessment of resection margins, the gold standard for confirming radical tumor resection, sometimes difficult. Objective To assess the different ways to manage patients depending on the status of the histopathological margin according to recent studies to detect the most commonly shared therapeutic strategy. Data Synthesis We analyzed the literature available on the PubMed and Web of Science databases, including only articles published since 2005, using specific keywords to retrieve articles whose titles and abstracts were read and analyzed independently by two authors to detect relevant studies. Therefore, we focused on disease-free survival, overall survival, local control, laryngeal preservation, and disease-specific survival. Thus, 17 studies were included in the present review; they were grouped according to the status of the histological margin, and we analyzed the different management policies described in them. This analysis showed that there is not a shared strategy, though in most studies the authors performed a second-look surgery in the cases of positive margins and a close follow-up in cases of negative ones. The main disagreement is regarding the management of close or non-valuable resection margins, since some some authors performed a second-look surgery, and others, a close follow-up. Conclusions Definitely, the most shared policy is the second-look surgery in case of positive surgical margins, and a close follow-up in case of close or non-valuable resection margins. Key Points

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The Prognostic Value of Adding Narrow‐Band Imaging in Transoral Laser Microsurgery for Early Glottic Cancer: A Review

Cited by 19 publications

References 31 publications

The usefulness of the narrow band imaging (NBI) in decision-making process regarding second look procedure (SL) in laryngeal cancer follow-up after transoral laser microsurgery

The usefulness of the narrow band imaging (NBI) in decision-making process regarding second look procedure (SL) in laryngeal cancer follow-up after transoral laser microsurgery

Laser Microsurgery Versus Radiotherapy Versus Open Partial Laryngectomy for T2 Laryngeal Carcinoma: A Systematic Review of Oncological Outcomes

Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

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