Abstract
BackgroundThe optimal surgical margins assessment is capital in oral squamous cell carcinoma (OSCC) management. We evaluated the clinical benefits of integrating intraoperative macroscopic margin (MM) assessment and narrow band imaging (NBI).MethodsSixteen OSCC patients eligible for surgery were prospectively enrolled. For each patient, 2 to 6 bioptic samples of MM and NBI margins were obtained and histologically analyzed for the presence of dysplasia and lymphocytes. Microvessel density was investigated by CD34 immunohistochemistry.ResultsTaken together, 104 specimens were analyzed, including 15% tumors, 33% MM, 33% NBI margins, and 19% MM-NBI overlapping margins. The NBI margins were closer to the lesion in 50% cases, while the same number of MM were more conservative than NBI, irrespective of the tumor site. The rate of histologically positive margins was similar among the two methods, akin to the microvessel density.ConclusionsMM assessment should be integrated but not replaced with the NBI technology to allow for more conservative surgery.
Highlights
The optimal surgical margins assessment is capital in oral squamous cell carcinoma (OSCC) management
The principle by which narrow band imaging (NBI) can be employed for surgical margin assessment is based on the evidence that neoangiogenesis is a crucial step in tumor growth and metastatic spread
Integration of macroscopic margin (MM) and NBI margins is superior to MM and NBI alone Taken together, 104 specimens were analyzed, including 16 (15.4%) tumors, 34 (32.7%) MM, 34 (32.7%) NBI
Summary
The optimal surgical margins assessment is capital in oral squamous cell carcinoma (OSCC) management. We evaluated the clinical benefits of integrating intraoperative macroscopic margin (MM) assessment and narrow band imaging (NBI). Oral squamous cell carcinoma (OSCC) is the most frequent histological type of head and neck cancer and one of the most prevalent malignant neoplasms worldwide [1]. The Narrow Band Imaging (NBI) technology have shown good performance and is currently employed in several Centers [9, 10]. This augmented reality tool increases the contrast between the epithelial surface and the subjacent vascular network, allowing for the visualization of the mucosal and submucosal (micro) vascular patterns. Several studies have demonstrated that microvessel density (MD) assessed by histological and immunohistochemical analysis can be employed as a prognostic biomarker for OSCC [11,12,13]
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