2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

Fiz et al.

Margin Status Impact in TLM

FIGURE 1 | Kaplan–Meier curves for the entire patients cohort showing disease-specific survival in relation to margin status. MS, positive multiple superficial margins; SS, positive single superficial margin; “ + ” symbol, censored observations.

those who received no further treatment (66.7%, p = NS). Detailed figures regarding additional treatments are available in Table 4 .

total laryngectomy, while 6.1% of those with positivity of the deep margin lost the larynx ( p < 0.01). No significant difference was observed in Group B. Detailed figures regarding RFS, DSS, and OP are shown in Table 3 . Impact of Additional Treatment Twelve of 94 patients (12.8%) with positive MS margins under- went additional treatment (11 TLM and 1 adjuvant RT) due to the presence of adjunctive histopathologic risk factors such as high-grade lesions, evidence of perineural spread and/or vascular embolization. The presence of such selection bias could explain why these patients had worse RFS (50%) than those who did not undergo re-treatment (69.5%, p = 0.03). Fifteen of 48 patients (31.2%) with positive deep margins underwent additional treatment (9 TLM and 6 adjuvant RT). Among these, additional treatment showed slight, though non-significant improvement of RFS (73.3%) compared with

Impact of HDTV-NBI on Margins Evaluation, RFS, DSS, and OP

In all patients, intraoperative use of HDTV-NBI allowed improved evaluation of surgical margins, with a greater proportion of negative margins (50 vs. 30%, p < 0.001), reduced number of CS (10 vs. 16%, p < 0.001), and multiple superficial margins (15 vs. 17%, p = 0.03). Improvement of the rate of negative margins was also observable in Group A (45 vs. 34%, p < 0.001) and in pT1a patients (44 vs. 31%, p < 0.001). Moreover, use of HDTV-NBI reduced the postoperative findings of CS (8 vs. 15%, p < 0.001) and multiple superficial positive margins (13 vs. 18%, p = 0.01) in both Group A and pT1a patients (9 vs. 18%, p < 0.001; 10 vs. 17%, p < 0.001, respectively).

Frontiers in Oncology | www.frontiersin.org

October 2017 | Volume 7 | Article 245

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