Cited by 2.3kOpen Access
Chiba Cancer Center
ORCID: 0000-0003-1513-7117Publishes on Gastric Cancer Management and Outcomes, Esophageal Cancer Research and Treatment, Esophageal and GI Pathology. 233 papers and 8.7k citations.
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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.
After publication of the guidelines, the Committee on Guidelines for Diagnosis and Treatment of Esophageal Cancer of the Japan Esophageal Society has taken the initiative to continue to review the contents of the guidelines and conduct public relations and dissemination/utilization activities.A revision of the guidelines is planned for approximately 5 years after publication of this guideline.In addition, a prompt report will be made when the results of a clinical study(ies) are published or in accordance with changes in the medical circumstances, such as revision of the health insurance coverage.