Diagnosis of the extent of advanced oropharyngeal and hypopharyngeal cancers by narrow band imaging with magnifying endoscopy

Laryngoscope. 2011 Apr;121(4):753-9. doi: 10.1002/lary.21553. Epub 2011 Feb 4.

Abstract

Objectives/hypothesis: Narrow band imaging combined with magnifying endoscopy (NBI-ME) is useful for the detection of superficial cancer in the oropharynx, hypopharynx, and esophagus. We used NBI-ME to evaluate the frequency of superficial cancer spread (SCS) contiguous with advanced oropharyngeal and hypopharyngeal cancers and esophageal cancers.

Study design: Retrospective.

Methods: We retrospectively studied 45 patients with oropharyngeal and hypopharyngeal cancer and 44 with esophageal cancer who underwent NBI-ME from October 2006 through April 2009. The following variables were evaluated: 1) the frequency of SCS contiguous with advanced oropharyngeal and hypopharyngeal cancer and esophageal cancer, and 2) the influence of SCS contiguous with advanced oropharyngeal and hypopharyngeal cancer on clinical T category and clinical stage.

Results: SCS contiguous with the primary tumor was found in 49% (22/45) of the patients with advanced oropharyngeal and hypopharyngeal cancer and in 52% (23/44) of those with advanced esophageal cancer. When SCS contiguous with the primary tumor was included in the evaluation of tumor size in advanced oropharyngeal and hypopharyngeal cancer, the clinical T category and clinical stage were revised in 20% (9/45) and 4% (2/45) of patients, respectively; SCS was ≤ 2 cm in 64% of cases (14/22) and between >2 cm and ≤ 4 cm in 36% (8/22).

Conclusions: NBI-ME should be included in the pretreatment diagnostic work-up to evaluate lesion extent and decide optimal surgical margins and radiation fields in patients with advanced oropharyngeal and hypopharyngeal cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / blood supply
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / pathology
  • Endoscopy / instrumentation*
  • Esophageal Neoplasms / blood supply
  • Esophageal Neoplasms / diagnosis*
  • Esophageal Neoplasms / pathology
  • Esophagoscopy / instrumentation*
  • Esophagus / pathology
  • Female
  • Humans
  • Hypopharyngeal Neoplasms / blood supply
  • Hypopharyngeal Neoplasms / diagnosis*
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharynx / pathology
  • Image Enhancement / methods*
  • Male
  • Microcirculation
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / blood supply
  • Oropharyngeal Neoplasms / diagnosis*
  • Oropharyngeal Neoplasms / pathology
  • Oropharynx / pathology
  • Retrospective Studies
  • Video Recording / instrumentation*