title: Magnifying endoscope with NBI to predict the depth of invasion in laryngo-pharyngeal cancer.
abstract: OBJECTIVE
  To examine if macroscopic classification with a magnifying gastrointestinal endoscope with narrow band imaging (ME-NBI) is useful in predicting pathological depth of tumor invasion in laryngo-pharyngeal cancer.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Preoperative endoscopy reports and postoperative pathological reports on 139 laryngo-pharyngeal cancer lesions were retrospectively reviewed, and the association between macroscopic findings in the lesions and the depth of tumor invasion was analyzed statistically.
  
  
  RESULTS
  The ratios of lesions macroscopically classified as 0-I (superficial and protruding), 0-IIa (slightly elevated), 0-IIb (true flat), 0-IIc (slightly depressed), and 0-III (superficial and excavated) in the preoperative endoscopy reports were 3%, 25%, 71%, 1%, and 0%, respectively. Regarding the depth of tumor invasion in the postoperative pathological reports, the ratios of lesions classified as EP (carcinoma in situ), SEP (tumor invades subepithelial layer), and MP (tumor invades muscularis propria) were 73%, 26%, and 1%, respectively. The ratios of subepithelial invasion or muscular invasion in 0-I, 0-IIa, and 0-IIb were 100%, 54%, and 14%, respectively, and showed significant difference (P < 0.0001). Only one of 139 lesions invaded the muscular propria.
  
  
  CONCLUSIONS
  This study is the first one to show that macroscopic findings by ME-NBI predict the depth of tumor invasion in superficial laryngo-pharyngeal cancer. It was indicated that there is a little chance of muscular invasion if the lesion is endoscopically diagnosed as 0-I or 0-II. A new T stage classification based on the depth of tumor invasion may be needed in order to adapt the classification to include transoral surgery.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tateya
authors.forename: Shuko
authors.initials: S
authors.lastname: Morita
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
authors.forename: Shin'ichi
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Hayashi
authors.forename: Makiko
authors.initials: M
authors.lastname: Funakoshi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Aoyama
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hirano
authors.forename: Morimasa
authors.initials: M
authors.lastname: Kitamura
authors.forename: Seiji
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Yo
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Mami
authors.initials: M
authors.lastname: Morita
authors.forename: Patnarin
authors.initials: P
authors.lastname: Mahattanasakul
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Juichi
authors.initials: J
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019723:Endoscopes; D004867:Equipment Design; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000295:instrumentation*; D009361:Neoplasm Invasiveness; D010610:Pharyngeal Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies
keywords: Magnifying endoscopy; TNM classification; endoscopic laryngo-pharyngeal surgery; narrow band imaging; transoral robotic surgery