Is NBI-Guided Resection a Breakthrough for Achieving Adequate Resection Margins in Oral and Oropharyngeal Squamous Cell Carcinoma?

Ann Otol Rhinol Laryngol. 2016 Jul;125(7):596-601. doi: 10.1177/0003489416641428. Epub 2016 Apr 7.

Abstract

Objectives: Obtaining free resection margins is the main goal of oncological surgeons. Narrow-band imaging (NBI) has been recently used to help define resection margins in transoral laser microsurgery for laryngeal carcinoma. The aim of this study was to evaluate the effect of intraoperative NBI in defining the surgical resection margins of oral and oropharyngeal cancers.

Methods: Between January 2014 and March 2015, NBI was used intraoperatively after an initial definition of resection margins with white light in 26 patients (group A). The rate of superficial positive margins at definitive histology was compared with that of a historical cohort of 44 patients (group B) previously managed without the use of intraoperative NBI.

Results: A statistically significant reduction in the rate of positive superficial margins was observed at definitive histology in group A (P = .028). NBI helped to identify the presence of dysplasia and cancer around the visible tumor not otherwise detectable with visual examination alone.

Conclusions: NBI could be a useful tool for obtaining free resection margins in oral and oropharyngeal carcinoma.

Keywords: OPSCC; OSCC; adequate margins; narrow-band imaging (NBI); oral cancer; oropharyngeal carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Margins of Excision*
  • Middle Aged
  • Mouth Neoplasms / diagnostic imaging
  • Mouth Neoplasms / surgery*
  • Narrow Band Imaging*
  • Oropharyngeal Neoplasms / diagnostic imaging
  • Oropharyngeal Neoplasms / surgery*
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Prospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Surgery, Computer-Assisted / methods*