Giancarlo Tirelli1, Marco Piovesana1, Alberto Vito Marcuzzo1, Annalisa Gatto1, Matteo Biasotto2, Rossana Bussani3, Lorenzo Zandonà4, Fabiola Giudici5, Francesca Boscolo Nata6. 1. ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 2. Ambulatorio di Patologia e Medicina Orale, Clinica Odontoiatrica e Stomatologica, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 3. UCO Pathological Anatomy and Histopathology Unit, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 4. DAI di Medicina di Laboratorio, Azienda Sanitaria-Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 5. Biostatistic Unit-Department of Medical, Surgical and Health Science, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 6. ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. Electronic address: fboscolonata@pec.omceotrieste.it.
Abstract
PURPOSE: In a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study. MATERIALS AND METHODS: The resection margins of 39 oral and 22 oropharyngeal squamous cell carcinomas were first set at 1.5cm from the macroscopic lesion boundary (white light, WL, tattoo). Then, the superficial tumor extension was more precisely defined with NBI, giving rise to three possible situations: NBI tattoo larger than the WL tattoo, NBI tattoo coinciding with the WL tattoo, or NBI tattoo smaller than the WL tattoo. For each of these situations the space comprised between the NBI and WL tattoos was defined "NBI positive", "NBI null", and "NBI negative", respectively. Resections were performed following the outer tattoo. The number of clear superficial resection margins, and the pathological response on the "NBI-positive" and the "NBI-negative" areas were recorded. RESULTS: We obtained 80.3% negative superficial resection margins. NBI provided a more precise definition of superficial tumor extension in 43 patients. Sensitivity, specificity, positive and negative predictive values were 94.4%, 64%, 79.1% and 88.9%, respectively; a test of proportions demonstrated they were not influenced by tumor site. CONCLUSIONS: NBI could allow for real-time definition of superficial tumor extension with possible tailored resections and fewer positive superficial resection margins; it is not influenced by tumor site.
PURPOSE: In a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study. MATERIALS AND METHODS: The resection margins of 39 oral and 22 oropharyngeal squamous cell carcinomas were first set at 1.5cm from the macroscopic lesion boundary (white light, WL, tattoo). Then, the superficial tumor extension was more precisely defined with NBI, giving rise to three possible situations: NBI tattoo larger than the WL tattoo, NBI tattoo coinciding with the WL tattoo, or NBI tattoo smaller than the WL tattoo. For each of these situations the space comprised between the NBI and WL tattoos was defined "NBI positive", "NBI null", and "NBI negative", respectively. Resections were performed following the outer tattoo. The number of clear superficial resection margins, and the pathological response on the "NBI-positive" and the "NBI-negative" areas were recorded. RESULTS: We obtained 80.3% negative superficial resection margins. NBI provided a more precise definition of superficial tumor extension in 43 patients. Sensitivity, specificity, positive and negative predictive values were 94.4%, 64%, 79.1% and 88.9%, respectively; a test of proportions demonstrated they were not influenced by tumor site. CONCLUSIONS: NBI could allow for real-time definition of superficial tumor extension with possible tailored resections and fewer positive superficial resection margins; it is not influenced by tumor site.
Authors: G Tirelli; F Boscolo Nata; R Bussani; A Gatto; E Quatela; S Rigo; M Piovesana Journal: Eur Arch Otorhinolaryngol Date: 2019-05-21 Impact factor: 2.503