The role of intraoperative narrow-band imaging in transoral laser microsurgery for early and moderately advanced glottic cancer

Klimza, Hanna; Jackowska, Joanna; Piazza, Cesare; Banaszewski, Jacek; Wierzbicka, Małgorzata

doi:10.1016/j.bjorl.2018.01.004

Cited by 19 publications

(39 citation statements)

References 24 publications

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“…Among these, five primary research papers met the minimum eligibility criteria and were included in the systematic review. They included three retrospective studies , one descriptive study , and one prospective study . The main characteristics of the selected studies (type of study, length of follow‐up, and principal endpoint investigated) are summarized in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Klimza et al reported the intraoperative use of NBI on a sample of 44 consecutive T1–T2 glottic cancers. All patients had clear margins in definitive histology and local recurrence was found in three of 44 patients (6.8%).…”

Section: Resultsmentioning

confidence: 99%

“…The proposal of an additional treatment, such as a new laser resection and/or RT, should be carefully discussed; alternatively, the patient may be sent to a close follow-up program. Additional treatments may cause some disadvantages such as the loss of other laryngeal tissue with Fiz et al [16] Piersialia et al [9] Plaat et al [11] Klimza et al [17] Total Total (%) consequent worsening of the quality of the voice [29]. Moreover, a complementary RT encompasses a multimodal therapeutic approach for early tumors that could have been managed by RT alone from the beginning [30].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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Background and Objectives Transoral laser microsurgery (TLM) is a universally recognized safe and minimally invasive approach for early glottic cancer. Narrow band imaging (NBI) is an optical technique working with a filtered light that reveals superficial mucosal abnormalities through the neoangiogenic pattern. The aim of this systematic review is to demonstrate the role of intraoperative NBI during TLM for early glottic cancer to better evaluate tumor extension and for more precise margin resection. Study Design/Materials and Methods A systematic review of the literature following the PRISMA guidelines was performed. A literature search was performed using the following keywords: TLM, NBI, and early glottic cancer. Two independent authors evaluated the extracted data. Data regarding status of surgical margins after TLM, local recurrence, recurrence‐free survival, and need of additional samples following NBI were collected. Results Five articles met inclusion criteria with a total of 577 patients undergoing TLM with intraoperative NBI. A significant reduction of positive superficial margins was found in patients treated with (52%) and without (28.6%) intraoperative use of NBI (P < 0.05) Conclusions Routine use of intraoperative NBI increases the accuracy of neoplastic superficial spreading evaluation and accuracy of mass resection during TLM for early glottic cancer. The significant reduction of superficial positive margins dramatically decreases the number of patients at risk and improves clinical outcomes. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…10,16 Thus, regarding the issue of white mucosal thickening, the surrounding mucosa should be analyzed for any vascular abnormalities with NBI. 5,15,19 Indeed, in the included studies 4,5,[14][15][16] reported that the SE and NPV of NBI were significantly greater than those of WL. In another study, Ni et al 16 reported that NBI was better than WL, especially concerning SP and PPV.…”

Section: Nbi Versus Wlmentioning

confidence: 94%

The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

Saraniti

Chianetta

Greco

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial vascular changes, is useful to detect suspicious laryngeal lesions, enabling their complete excision with safe and tailored resection margins. Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant and malignant laryngeal lesions through a comparison with white-light endoscopy. Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases using strict keywords. Then, two authors independently analyzed the articles, read the titles and abstracts, and read completely only the relevant studies according to certain eligibility criteria. In total, 14 articles have been included in the present review; the sensitivity, specificity, positive and negative predictive values, and accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity, specificity, positive and negative predictive values, and accuracy regarding the ability to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative performance of narrow-band imaging resulted more effective than the in-office performance. Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging is useful in cases of leukoplakia that may cover a possible malignant lesion and that cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and practical classification of laryngeal lesions, such as that of the European Laryngological Society, is required to identify a shared lesion management strategy. Key Points

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“…The aforementioned findings in NBI are identified as well-demarcated areas with scattered brownish spots [ 3 ]. It has been proven that narrow band imaging (NBI) is a useful tool in the detection of early glottic cancer and in the intraoperative delineation of superficial margins during cordectomy [ 4 – 6 ]. It has also been showed that NBI guides clinical decision-making regarding treatment of patients with laryngeal leukoplakia [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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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The role of intraoperative narrow-band imaging in transoral laser microsurgery for early and moderately advanced glottic cancer

Abstract: The intraoperative use of narrow-band imaging proved to be valuable in the visualization of suspect areas of the mucosa. Narrow-band imaging confirms the suspicions undertaken in white light and importantly, it showed microlesions beyond the scope of white light.

Cited by 19 publications

References 24 publications

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

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

The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

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

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