Intraoperative Imaging Techniques to Improve Surgical Resection Margins of Oropharyngeal Squamous Cell Cancer: A Comprehensive Review of Current Literature †
de Kleijn, Bertram J.; Heldens, Gijs T.N.; Herruer, Jasmijn M.; Sier, Cornelis F.M.; Piazza, Cesare; de Bree, Remco; Guntinas-Lichius, Orlando; Kowalski, Luiz P.; Vander Poorten, Vincent; Rodrigo, Juan P.; Zidar, Nina; Nathan, Cherie Ann; Tsang, Raymond K.; Golusinski, Pawel; Shaha, Ashok R.; Ferlito, Alfio; Takes, Robert P.
(2023) Cancers, volume 15, issue 3
(Article)
Abstract
Inadequate resection margins in head and neck squamous cell carcinoma surgery necessitate adjuvant therapies such as re-resection and radiotherapy with or without chemotherapy and imply increasing morbidity and worse prognosis. On the other hand, taking larger margins by extending the resection also leads to avoidable increased morbidity. Oropharyngeal squamous cell
... read more
carcinomas (OPSCCs) are often difficult to access; resections are limited by anatomy and functionality and thus carry an increased risk for close or positive margins. Therefore, there is a need to improve intraoperative assessment of resection margins. Several intraoperative techniques are available, but these often lead to prolonged operative time and are only suitable for a subgroup of patients. In recent years, new diagnostic tools have been the subject of investigation. This study reviews the available literature on intraoperative techniques to improve resection margins for OPSCCs. A literature search was performed in Embase, PubMed, and Cochrane. Narrow band imaging (NBI), high-resolution microendoscopic imaging, confocal laser endomicroscopy, frozen section analysis (FSA), ultrasound (US), computed tomography scan (CT), (auto) fluorescence imaging (FI), and augmented reality (AR) have all been used for OPSCC. NBI, FSA, and US are most commonly used and increase the rate of negative margins. Other techniques will become available in the future, of which fluorescence imaging has high potential for use with OPSCC.
show less
Download/Full Text
Keywords: (auto) fluorescence imaging, augmented reality, computed tomography, confocal laser endomicroscopy, frozen section analysis, high resolution microendoscopic imaging, intraoperative imaging, narrow band imaging, transoral surgery, ultrasound, Oncology, Cancer Research, Review, Journal Article
ISSN: 2072-6694
Publisher: Multidisciplinary Digital Publishing Institute (MDPI)
Note: Publisher Copyright: © 2023 by the authors.
(Peer reviewed)