Objective: The high rate of positive margins after transoral laser microsurgery (TLM) remains a matter of debate. This study investigates the effect of intraoperative narrow band imaging (NBI) examination on the incidence of positive superficial surgical margins in early glottic cancer treated by TLM. Methods: Between January 2012 and October 2013, 82 patients affected by Tis-T1a glottic cancer were treated with TLM by type I or II cordectomies. Intraoperative NBI evaluation was performed using 0-degree and 70-degree rigid telescopes. Surgical specimens were oriented by marking the superior edge with black ink and sent to a dedicated pathologist. Comparison between the rate of positive superficial margins in the present cohort and in a matched historical control group treated in the same way without intraoperative NBI was calculated by chi-square test. Results: At histopathological examination, all surgical margins were negative in 70 patients, whereas 7 had positive deep margins, 2 close, and 3 positive superficial margins. The rate of positive superficial margins was thus 3.6% in the present group and 23.7% in the control cohort (P <.001). Conclusion: Routine use of intraoperative NBI increases the accuracy of neoplastic superficial spreading evaluation during TLM for early glottic cancer.

Intraoperative Narrow Band Imaging Better Delineates Superficial Resection Margins during Transoral Laser Microsurgery for Early Glottic Cancer / S. Garofolo, C. Piazza, F. Del Bon, S. Mangili, L. Guastini, F. Mora, P. Nicolai, G. Peretti. - In: ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY. - ISSN 0003-4894. - 124:4(2015), pp. 294-298. [10.1177/0003489414556082]

Intraoperative Narrow Band Imaging Better Delineates Superficial Resection Margins during Transoral Laser Microsurgery for Early Glottic Cancer

C. Piazza
;
2015

Abstract

Objective: The high rate of positive margins after transoral laser microsurgery (TLM) remains a matter of debate. This study investigates the effect of intraoperative narrow band imaging (NBI) examination on the incidence of positive superficial surgical margins in early glottic cancer treated by TLM. Methods: Between January 2012 and October 2013, 82 patients affected by Tis-T1a glottic cancer were treated with TLM by type I or II cordectomies. Intraoperative NBI evaluation was performed using 0-degree and 70-degree rigid telescopes. Surgical specimens were oriented by marking the superior edge with black ink and sent to a dedicated pathologist. Comparison between the rate of positive superficial margins in the present cohort and in a matched historical control group treated in the same way without intraoperative NBI was calculated by chi-square test. Results: At histopathological examination, all surgical margins were negative in 70 patients, whereas 7 had positive deep margins, 2 close, and 3 positive superficial margins. The rate of positive superficial margins was thus 3.6% in the present group and 23.7% in the control cohort (P <.001). Conclusion: Routine use of intraoperative NBI increases the accuracy of neoplastic superficial spreading evaluation during TLM for early glottic cancer.
early glottic cancer; narrow band imaging; resection margins; transoral laser microsurgery; Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Glottis; Humans; Laryngeal Neoplasms; Laser Therapy; Male; Microsurgery; Middle Aged; Monitoring, Intraoperative; Mouth; Narrow Band Imaging; Natural Orifice Endoscopic Surgery; Neoplasm Staging; Retrospective Studies; Otorhinolaryngology; 2734; Pathology and Forensic Medicine
Settore MED/31 - Otorinolaringoiatria
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/622396
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