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Follow-up of oral and oropharyngeal cancer using narrow-band imaging and high-definition television with rigid endoscope to obtain an early diagnosis of second primary tumors: a prospective study

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Abstract

Narrow-band imaging (NBI) is an optical technique enhancing mucosal vasculature. The aim of this study is to assess the effectiveness of rigid NBI endoscopy in the early detection of second primaries or local recurrences after treatment for oral (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC), its advantage over standard white-light (WL) endoscopy, and the influence of previous radiotherapy, the learning curve, and lesion site. Between January 2013 and June 2015, 195 patients treated for OSCC or OPSCC with surgery alone (group A) or radiotherapy with or without surgery and/or chemotherapy (group B) underwent additional follow-up assessments using NBI. Sensitivity, specificity, positive/negative predictive values (PPV and NPV), and accuracy for detecting second primaries or local recurrences were calculated for patients with at least two NBI assessments. The effect of previous radiotherapy was determined by test of proportions and that of the learning curve and lesion site with Fisher’s exact test. 138/195 patients were included in the analysis. NBI sensitivity, specificity, PPV, NPV, and accuracy for groups A and B were 89.5 vs 100%, 85.2 vs 81.5%, 65.4 vs 69.7%, 96.3 vs 100%, and 86.3 vs 87%, respectively. The diagnostic gain of NBI was 88.2% in group A and 69.6% in group B. The learning curve was the main source of false positives (p = 0.025), whereas radiotherapy and lesion site were uninfluential (p = NS). NBI appears useful for follow-up after treatment for OSCC or OPSCC, its performance being affected only by the learning curve and not by previous treatment or lesion site.

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Acknowledgements

The authors thank Itala Mary Ann Brancaleone, M.A., RSA Dip TEFLA, teacher of Medical English at the University of Trieste, for help with language editing of the manuscript. The authors thank Dr Lucio Torelli, D.Sc., professor of medical statistics at the University of Trieste, for his help with statistical analysis of the data.

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Authors and Affiliations

  1. Head and Neck Department, ENT Clinic, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149, Trieste, Italy

    Giancarlo Tirelli, Marco Piovesana, Pierluigi Bonini, Annalisa Gatto & Francesca Boscolo Nata

  2. Department of Medical Oncology, Mirano Hospital, Local Health Unit 13, Mirano, Venezia, Italy

    Giuseppe Azzarello

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  1. Giancarlo Tirelli
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  2. Marco Piovesana
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  3. Pierluigi Bonini
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  6. Francesca Boscolo Nata
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Correspondence to Francesca Boscolo Nata.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Tirelli, G., Piovesana, M., Bonini, P. et al. Follow-up of oral and oropharyngeal cancer using narrow-band imaging and high-definition television with rigid endoscope to obtain an early diagnosis of second primary tumors: a prospective study. Eur Arch Otorhinolaryngol 274, 2529–2536 (2017). https://doi.org/10.1007/s00405-017-4515-x

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  • DOI: https://doi.org/10.1007/s00405-017-4515-x

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