The assessment of mucosal surgical margins in head and neck cancer surgery with narrow band imaging

Abstract

Objectives/hypothesis: The diagnostic gain of narrow band imaging in the definition of surgical margins in the treatment of head and neck cancer was evaluated.

Study design: A prospective study, blinded to the pathologist, with historical comparison.

Methods: The study group included 45 patients subjected to the intraoperative definition of margins by narrow band imaging. The control group included 55 patients who had undergone standard definition of margins. All patients underwent resection of the tumor and frozen section analysis of superficial margins. The rate of initial R₀ resection and the ratio of histologically negative margins for both groups were statistically compared.

Results: The rate of initial R₀ resection in the study group and in the control group was 88.9% and 70.9% (P = .047), and the ratio of histologically negative margins was 95.9% and 88.4% (P = .017), respectively.

Conclusions: Narrow band imaging reveals a microscopic extension of the tumor that could be effectively used to better define superficial margins and to achieve a higher rate of initial R₀ resections.

Level of evidence: 4 Laryngoscope, 127:1577-1582, 2017.

Keywords: Surgical margins; frozen section; head and neck cancer; narrow band imaging.