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Role of narrow-band imaging and high-definition television in the surveillance of head and neck squamous cell cancer after chemo- and/or radiotherapy

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Abstract

Narrow-band imaging (NBI) is an endoscopic technique enhancing mucosal vasculature and better identifying superficial carcinomas due to their neo-angiogenic pattern. NBI accuracy is increased by combination with a high-definition television (HDTV) camera. The aim of this report was to evaluate the diagnostic improvement of NBI ± HDTV in the evaluation of head and neck squamous cell cancer (HNSCC) previously treated by chemo-radiotherapy (CHT-RT) or RT. A total of 390 patients affected by HNSCC were prospectively evaluated by NBI and white light (WL) endoscopy ± HDTV between April 2007 and April 2009 at a single academic institution. Among them, we focused on 59 (15%) patients who received CHT-RT or RT as part of their treatment. Of 59 patients, 13 (22%) showed adjunctive preoperative NBI findings when compared to the standard WL examination. These findings were always confirmed by intraoperative HDTV NBI, while only eight (62%) were visible with HDTV WL. Of 13 lesions, 12 received histopathologic confirmation (from carcinoma in situ to invasive carcinoma). The sensitivity of flexible NBI, HDTV WL, and HDTV NBI was 100, 66 and 100%, respectively. The specificity was 98, 100, and 98%. The positive predictive value was 92, 100, and 92%. The negative predictive value was 100, 94, and 100%. The accuracy was 98, 91, and 98%. NBI ± HDTV after CHT-RT or RT was of value in detecting tumor persistence (n = 2), early recurrences (n = 6), and metachronous tumors (n = 4). By contrast, only 1 of 59 (2%) patients was found to be false positive.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy

    Cesare Piazza, Daniela Cocco, Luigi De Benedetto, Francesca Del Bon, Piero Nicolai & Giorgio Peretti

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  1. Cesare Piazza
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  2. Daniela Cocco
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  3. Luigi De Benedetto
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  4. Francesca Del Bon
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  5. Piero Nicolai
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  6. Giorgio Peretti
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Corresponding author

Correspondence to Cesare Piazza.

Additional information

Best Poster Award for Head and Neck Surgery at the 1st Meeting of the European Academy of ORL-HNS in collaboration with EUFOS, Congress Center Rosengarten, Mannheim, Germany, 27–30 June 2009.

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Piazza, C., Cocco, D., De Benedetto, L. et al. Role of narrow-band imaging and high-definition television in the surveillance of head and neck squamous cell cancer after chemo- and/or radiotherapy. Eur Arch Otorhinolaryngol 267, 1423–1428 (2010). https://doi.org/10.1007/s00405-010-1236-9

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  • DOI: https://doi.org/10.1007/s00405-010-1236-9

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