Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: A multicenter randomized controlled trial

Manabu Muto, Keiko Minashi, Tomonori Yano, Yutaka Saito, Ichiro Oda, Satoru Nonaka, Tai Omori, Hitoshi Sugiura, Kenichi Goda, Mitsuru Kaise, Haruhiro Inoue, Hideki Ishikawa, Atsushi Ochiai, Tadakazu Shimoda, Hidenobu Watanabe, Hisao Tajiri, Daizo Saito

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Abstract

Purpose: Most of the esophageal squamous cell carcinomas (ESCCs) and cancers of the head and neck (H&N) region are diagnosed at later stages. To achieve better survival, early detection is necessary. We compared the real-time diagnostic yield of superficial cancer in these regions between conventional white light imaging (WLI) and narrow band imaging (NBI) in high-risk patients. Patients and Methods: In a multicenter, prospective, randomized controlled trial, 320 patients with ESCC were randomly assigned to primary WLI followed by NBI (n = 162) or primary NBI followed by WLI (n = 158) in a back-to-back fashion. The primary aim was to compare the real-time detection rates of superficial cancer in the H&N region and the esophagus between WLI and NBI. The secondary aim was to evaluate the diagnostic accuracy of these techniques. Results: NBI detected superficial cancer more frequently than did WLI in both the H&N region and the esophagus (100% v 8%, P < .001; 97% v 55%, P < .001, respectively). The sensitivity of NBI for diagnosis of superficial cancer was 100% and 97.2% in the H&N region and the esophagus, respectively. The accuracy of NBI for diagnosis of superficial cancer was 86.7% and 88.9% in these regions, respectively. The sensitivity and accuracy were significantly higher using NBI than WLI in both regions (P < .001 and P = .02 for the H&N region; P < .001 for both measures for the esophagus, respectively). Conclusion: NBI could be the standard examination for the early detection of superficial cancer in the H&N region and the esophagus.

Original languageEnglish
Pages (from-to)1566-1572
Number of pages7
JournalJournal of Clinical Oncology
Volume28
Issue number9
DOIs
Publication statusPublished - 2010 Mar 20

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Muto, M., Minashi, K., Yano, T., Saito, Y., Oda, I., Nonaka, S., Omori, T., Sugiura, H., Goda, K., Kaise, M., Inoue, H., Ishikawa, H., Ochiai, A., Shimoda, T., Watanabe, H., Tajiri, H., & Saito, D. (2010). Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: A multicenter randomized controlled trial. Journal of Clinical Oncology, 28(9), 1566-1572. https://doi.org/10.1200/JCO.2009.25.4680