Evidence map›Paper›PMID 32764755›Full record

ArticlePloS one2020

The usefulness of the narrow band imaging (NBI) in decision-making process regarding second look procedure (SL) in laryngeal cancer follow-up after transoral laser microsurgery.

Joanna Witkiewicz, Hanna Klimza, Krzysztof Piersiala, Joanna Jackowska, Małgorzata Wierzbicka

Abstract read
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In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. European Laryngological Society consensus statement on optimal monitoring schedules after treatment for early glottic cancer: a risk-stratification.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Joanna WitkiewiczDepartment of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.
Hanna KlimzaDepartment of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.
Krzysztof PiersialaDivision of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-3844-5999
Joanna JackowskaDepartment of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.
Małgorzata WierzbickaDepartment of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prognostic value of positive surgical margins after transoral laser microsurgery (TOLM) is still under debate. In case of positive superficial margins, some experts recommend a second-look surgery (SL) and some recommend wait and watch approach with close observation. Narrow band imaging (NBI) is an advanced imaging system used to enhance visualization of mucosal vascular pattern. In laryngology, NBI is used to improve the detection of premalignant, dysplastic and malignant lesions.

aimTo assess the usefulness of NBI imaging in guiding clinical decision making regarding follow-up plan and SL after TOLM. MATERIALS AND

methodsA prospective cohort of 127 patients was divided into three groups based on the histology results and NBI vascular pattern of the mucosa. Group A (24/127, 18.90%) consisted of patients with suspicious vascular pattern in NBI or/and with positive deep margin. Group B (52/127, 40.94%) consisted of patients with positive or uncertain superficial margins and non-suspicious vascular pattern in NBI. Group C (51/127, 40.15%) had non-suspicious vascular NBI pattern and all negative margins.

resultsAfter the first TOLM procedure, 9/24 (37.5%) patients had positive deep margins, 1/24 (4.2%) had uncertain deep margin and 1/24 patient (4.2%) had both positive deep margin and suspicious vascular pattern in NBI. The remaining 13 cases in Group A had a suspicious NBI finding only during the first follow-up. All of the 24 patients (Group A) underwent a second look surgery. The final histology after SL showed squamous cell carcinoma in 10/24 (41.7%) patients. All 10 patients had suspicious vascular pattern in NBI and one patient had both a positive deep margins after the first TOLM and positive NBI finding. None of Group B and C subjects developed an early recurrence.

conclusionsOur study provides evidence that NBI imaging will be a useful adjunct to margin status after TOLM and will facilitate clinical decision-making regarding performing the SL in patients with positive or uncertain superficial surgical margins in the first TOLM procedure. However, additional investigation with more subjects is required at this time to further validate this technique and change the standard of care.

Indexed as

Laser TherapyMicrosurgeryNarrow Band ImagingSecond-Look SurgeryAdultAgedAged, 80 and overCarcinoma, Squamous CellClinical Decision-MakingFemaleFollow-Up StudiesHumansLaryngeal NeoplasmsMaleMargins of ExcisionMiddle Aged

Identifiers

PMID32764755
PMCPMC7413545

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.