Surgical Oncology 36 (2021) 65–75 Available online 1 December 2020 0960-7404/© 2020 Elsevier Ltd. All rights reserved. NBI utility in oncologic surgery: An organ by organ review Francesca Boscolo Nata a, b, * , Giancarlo Tirelli a , Vincenzo Capriotti a , Alberto Vito Marcuzzo a , Erica Sacchet a , Azzurra Nicole ˇ Suran-Brunelli a , Nicol` o de Manzini c a ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy b Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud “Madre Teresa di Calcutta”, ULSS 6 Euganea, Via Albere 30, 35043, Monselice, PD, Italy c General Surgery Unit, Department of Medical, Surgical and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy A R T I C L E INFO Keywords: Narrow band imaging NBI Cancer Intraoperative Follow up Survival ABSTRACT The main aims of the oncologic surgeon should be an early tumor diagnosis, complete surgical resection, and a careful post-treatment follow-up to ensure a prompt diagnosis of recurrence. Radiologic and endoscopic methods have been traditionally used for these purposes, but their accuracy might sometimes be suboptimal. Techno- logical improvements could help the clinician during the diagnostic and therapeutic management of tumors. Narrow band imaging (NBI) belongs to optical image techniques, and uses light characteristics to enhance tissue vascularization. Because neoangiogenesis is a fundamental step during carcinogenesis, NBI could be useful in the diagnostic and therapeutic workup of tumors. Since its introduction in 2001, NBI use has rapidly spread in different oncologic specialties with clear advantages. There is an active interest in this topic as demonstrated by the thriving literature. It is unavoidable for clinicians to gain in-depth knowledge about the application of NBI to their specifc feld, losing the overall view on the topic. However, by looking at other felds of application, clinicians could fnd ideas to improve NBI use in their own specialty. The aim of this review is to summarize the existing literature on NBI use in oncology, with the aim of providing the state of the art: we present an overview on NBI felds of application, results, and possible future improvements in the different specialties. 1. Introduction Cancer represents a public health problem worldwide. The estimated cumulative number of new cases in the United States (USA) for 2020 is 1,806,590 with 606,520 estimated deaths [1]. Educational campaigns against smoking and consequent population changes in cancer risk factors, screening test use and diagnostic practices could justify the decrease observed in cancer deaths [2]. Research has demonstrated that an early tumor diagnosis ensures a therapy with curative intent, a less invasive surgery with lower impact on function- ality, and consequently on patients’ quality of life [2]. Moreover a complete tumor removal with negative resection margins ensures a good impact on prognosis [3–7]. Consequently, irrespective of the cancer type and location, the main aim of the oncologic surgeon should be an early diagnosis, a complete surgical resection, and a careful post-treatment follow-up to ensure a prompt diagnosis of persistent, recurrent or secondary tumor. The NCCN guidelines provide indications for follow-up schedules, with laboratory, endoscopic and radiologic examinations [8]. Besides traditional investigation methods, technical advancements could help the clinician in such an ambitious mission. Among these, narrow band imaging (NBI) has largely demonstrated its potential as a diagnostic and therapeutic aid in different specialties. The frst pilot study demonstrating its use and ability to observe surface structure and capillary vessels in patients with esophageal, gastric and colorectal le- sions, was reported by Sano et al. in 2001 [9]. Since then, the use of NBI has rapidly spread among clinicians, with an increasing number of publications on this technology. Due to hyperspecialisation, clinicians have in-depth knowledge of the use of NBI in their specifc feld, but inevitably lose the overall view on the topic. In the present paper we present a review of the existing literature on NBI use in oncology, with the aim of providing the state of the art of NBI through an overview on its felds of application, results obtained, and possible future improvements in the different specialties. * Corresponding author. ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy. E-mail addresses: francesca.boscolonata@gmail.com (F. Boscolo Nata), tirelli.giancarlo@gmail.com (G. Tirelli), vince.capriotti@gmail.com (V. Capriotti), a.v. marcuzzo@gmail.com (A.V. Marcuzzo), erica.sacchet91@gmail.com (E. Sacchet), azzurra.nicole@gmail.com (A.N. ˇ Suran-Brunelli), ndemanzini@units.it (N. de Manzini). Contents lists available at ScienceDirect Surgical Oncology journal homepage: http://www.elsevier.com/locate/suronc https://doi.org/10.1016/j.suronc.2020.11.017 Received 18 June 2020; Accepted 26 November 2020