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The Prognostic Value of Adding Narrow‐Band Imaging in Transoral Laser Microsurgery for Early Glottic Cancer: A Review
Author(s) -
Campo Flaminia,
D'Aguanno Vittorio,
Greco Antonio,
Ralli Massimo,
Vincentiis Marco
Publication year - 2020
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.23142
Subject(s) - transoral laser microsurgery , medicine , microsurgery , stroboscope , cancer , radiology , surgery , resection , margin (machine learning) , larynx , laryngeal neoplasm , engineering , machine learning , computer science , electrical engineering
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.