An evaluation of in-office flexible fiber-optic biopsies for laryngopharyngeal lesions

Lee, Francisco; Smith, Kristine A.; Chandarana, Shamir; Matthews, T. Wayne; Bosch, J. Douglas; Nakoneshny, Steven C.; Dort, Joseph C.

doi:10.1186/s40463-018-0275-x

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…As seen in Table 5, in contrast, Lee et al [25] did not find any significant difference for timeto-treatment, despite observing a reduced time-to-diagnosis by 15.5 days with IOB. They account for the loss of this initial advantage of IOB due to a combination of system factors and referral bias.…”

Section: Waiting Timesmentioning

confidence: 70%

A systematic review: impact of in-office biopsy on safety and waiting times in head and neck cancer

et al. 2022

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Objective This study aimed to assess the current literature on the safety and impact of in-office biopsy on cancer waiting times as well as review evidence regarding cost-efficacy and patient satisfaction. Method A search of Cinahl, Cochrane Library, Embase, Medline, Prospero, PubMed and Web of Science was conducted for papers relevant to this study. Included articles were quality assessed and critically appraised. Results Of 19 741 identified studies, 22 articles were included. Lower costs were consistently reported for in-office biopsy compared with operating room biopsy. Four complications requiring intervention were documented. In-office biopsy is highly tolerated, with a procedure abandonment rate of less than 1 per cent. When compared with operating room biopsy, it is associated with significantly reduced time-to-diagnosis and time-to-treatment initiation. It is linked to improved overall three-year survival. Conclusion In-office biopsy is a safe procedure that may help certain patients avoid general anaesthetic. It was shown to significantly reduce time-to-diagnosis and time-to-treatment initiation when compared with operating room biopsy. This may have important implications for oncological outcomes. In-office biopsy requires fewer resources and is likely to be cost-saving five-years following introduction. With high rates of sensitivity and specificity, in-office biopsy should be considered as the first-line procedure to achieve tissue diagnosis.

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Section: Waiting Timesmentioning

confidence: 70%

A systematic review: impact of in-office biopsy on safety and waiting times in head and neck cancer

et al. 2022

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“…Lee et al . 31 performed a retrospective study on 114 patients, of which 44 underwent out-patient biopsy. They looked at time to diagnosis and treatment between the two groups.…”

Section: Resultsmentioning

confidence: 99%

“…Diagnosis using in-office endoscopic biopsy has been shown to be more time efficient, possibly leading to a better patient outcome. Lee et al 31 performed a retrospective study on 114 patients, of which 44 underwent out-patient biopsy. They looked at time to diagnosis and treatment between the two groups.…”

Section: Time For Diagnosismentioning

confidence: 99%

A systematic review on efficacy, safety and cost-effectiveness of office-based laryngeal biopsy

et al. 2022

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Objective Laryngeal cancer is the second most prevalent head and neck malignancy in the USA. With recent advances in technology, this procedure is increasingly performed under local anaesthesia. This study aimed to identify the efficacy, safety and cost-effectiveness of laryngeal biopsy in out-patients by conducting a systematic review. Method A literature search was conducted using PubMed, Medline, Google Scholar and Embase over a 20-year period. Inclusion criteria were: studies performed on out-patient diagnostic biopsy procedures of the larynx. Exclusion criteria included all therapeutic procedures. The outcome measures were sensitivity and specificity, complication rate and cost-savings. Results Thirty-five studies were included in the analysis. The sensitivity and specificity varied from 60 to 100 per cent with a low complication rate and cost savings. Conclusion Office-based laryngeal biopsies are increasingly used in the diagnosis of laryngeal cancers, resulting in earlier diagnosis and commencement of treatment. The barrier to undertaking this procedure is low sensitivity.

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“…FEB, however, is a less invasive alternative. Advantages of FEB include the elimination of GA, 5 negation of patients' anatomical limitations, 14 shortened time to diagnosis, 8,15 and reduction in health care costs. 2,7 Previous studies have demonstrated that FEB is safe, 1−6,9−12 feasible, 2,3,6,7 and tolerated by patients.…”

Section: Introductionmentioning

confidence: 99%

Flexible Endoscopic Biopsy: Identifying Factors to Increase Accuracy in Diagnosing Benign and Malignant Laryngopharyngeal Pathology

et al. 2022

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Objectives. To assess the influence that several factors, such as the amount of obtained biopsies, difficult procedures, biopsy site and the experience of the attending physician, have on accuracy of flexible endoscopic biopsy (FEB). Materials and methods. 203 FEB procedures for benign or malignant laryngopharyngeal lesions were prospectively included. During the procedure, three representative biopsies (macroscopically containing vital tumor tissue and not only necrosis or healthy tissue) were obtained. The accuracy of each biopsy was separately analyzed. Difficulties during the procedures leading to failure of acquiring three representative biopsies were recorded and classified into tumor, patient and procedural factors. Histological results of FEB were defined correct when consistent with clinical context, additional biopsies or Positron emission tomography-computed tomography (PET-CT) revealed equivalent pathology, or the lesion was stable or resolved in >6 months follow-up. Results. The first representative biopsy yielded a correct diagnosis in 65% of the cases. After the second representative biopsy, 78% was correctly diagnosed. The contribution of the third and fourth representative biopsies to accuracy was 3%. The overall accuracy of FEB was 85%. Difficult procedures were more likely to result in misdiagnosis, whereas biopsy site or experience of the attending physician did not influence results. Conclusions. FEB was accurate in diagnosing laryngopharyngeal lesions when at least two representative biopsies were obtained. Accuracy of FEB could be further improved by limiting possible constraints during the procedures, for example by selecting, informing, and anesthetizing patients carefully.

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An evaluation of in-office flexible fiber-optic biopsies for laryngopharyngeal lesions

Cited by 8 publications

References 10 publications

A systematic review: impact of in-office biopsy on safety and waiting times in head and neck cancer

A systematic review: impact of in-office biopsy on safety and waiting times in head and neck cancer

A systematic review on efficacy, safety and cost-effectiveness of office-based laryngeal biopsy

Flexible Endoscopic Biopsy: Identifying Factors to Increase Accuracy in Diagnosing Benign and Malignant Laryngopharyngeal Pathology

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