A novel integrated platform for the identification of surgical margins in oral squamous cell carcinoma: results from a prospective single-institution series

Baj, A.; Fusco, Nicola; Bolzoni, Alessandro; Carioli, Daniela; Mazzucato, Camilla; Faversani, Alice; Bresciani, Lorenzo; Maggioni, Marco; Capaccio, Pasquale

doi:10.1186/s12885-019-5634-0

Cited by 5 publications

(31 citation statements)

References 34 publications

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“…Considering applicability, only two studies scored sufficiently in the category ‘patient selection’; Baj et al [ 33 ] and Sun et al [ 34 ] included both early and advanced-stage oral SCC. Durham scored insufficiently for this category, as they did only include small (T1 and T2) tumors or “high grade lesions” defined as dysplasia or in situ carcinoma.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, these studies were excluded from further analysis ( Figure 1 ). Despite other studies scoring ‘insufficient’ on other categories as well [ 33 , 34 , 36 ], we decided to evaluate their margin visualization technique in this systematic review since it was possible to determine their diagnostic accuracy. This left eight studies for final evaluation.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies assessed iodine staining [ 38 , 39 ]. Four included studies analyzed NBI [ 33 , 40 , 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

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Intraoperative Techniques That Define the Mucosal Margins of Oral Cancer In-Vivo: A Systematic Review

de Koning,

Adriaansens,

Noorlag

et al. 2024

Cancers

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Background: This systematic review investigates techniques for determining adequate mucosal margins during the resection of oral squamous cell carcinoma (SCC). The primary treatment involves surgical removal with ≥5 mm margins, highlighting the importance of accurate differentiation between SCC and dysplasia during surgery. Methods: A comprehensive Embase and PubMed literature search was performed. Studies underwent quality assessment using QUADAS-2. Results: After the full-text screening and exclusion of studies exhibiting high bias, eight studies were included, focusing on three margin visualization techniques: autofluorescence, iodine staining, and narrow-band imaging (NBI). Negative predictive value (NPV) was calculable across the studies, though reference standards varied. Results indicated NPVs for autofluorescence, iodine, and NBI ranging from 61% to 100%, 92% to 99%, and 86% to 100%, respectively. Autofluorescence did not significantly enhance margins compared to white light-guided surgery, while iodine staining demonstrated improvement for mild or moderate dysplasia. NBI lacked comparison with a white light-guided surgery cohort. Conclusions: We recommend studying and comparing the diagnostic accuracy of iodine staining and NBI in larger cohorts of patients with oral SCC, focusing on discriminating between SCC and (severe) dysplasia. Furthermore, we advise reporting the diagnostic accuracy alongside the treatment effects to improve the assessment of these techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Intraoperative Techniques That Define the Mucosal Margins of Oral Cancer In-Vivo: A Systematic Review

de Koning,

Adriaansens,

Noorlag

et al. 2024

Cancers

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“…Patients with recurrent or metastatic head and neck squamous-cell carcinoma (HNSCC) after platinum chemotherapy have a dramatically poor prognosis and limited therapeutic options [81]. The immune-checkpoint blockade has only recently been demonstrated to be beneficial in these patients [38].…”

Section: Immune-related Biomarkers In Solid Tumors: Prognostic Andmentioning

confidence: 99%

Targeting Immune-Related Biological Processes in Solid Tumors: We do Need Biomarkers

Pagni

Guerini-Rocco

Schultheis

et al. 2019

IJMS

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Immunotherapy has become the standard-of-care in many solid tumors. Despite the significant recent achievements in the diagnosis and treatment of cancer, several issues related to patients’ selection for immunotherapy remain unsolved. Multiple lines of evidence suggest that, in this setting, the vision of a single biomarker is somewhat naïve and imprecise, given that immunotherapy does not follow the rules that we have experienced in the past for targeted therapies. On the other hand, additional immune-related biomarkers that are reliable in real-life clinical practice remain to be identified. Recently, the immune-checkpoint blockade has been approved in the US irrespective of the tumor site of origin. Further histology-agnostic approvals, coupled with with tumor-specific companion diagnostics and guidelines, are expected in this field. In addition, immune-related biomarkers can also have a significant prognostic value. In this review, we provide an overview of the role of these biomarkers and their characterization in the management of lung cancer, melanoma, colorectal cancer, gastric cancer, head and neck cancer, renal cell carcinoma, urothelial cancers, and breast cancer.

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“…Several diagnostic methods have been used for intraoperative identification of tumor-involved margins, including visualization and palpation of the resected margins, touch imprint cytology, microendoscope, fluorescent techniques, Raman spectroscopy, narrow-band imaging, and optical coherence tomography [6][7][8]. These methods have their challenges and limitations in terms of appropriate performance, practicality, and cost-effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Toluidine blue versus frozen section for assessment of mucosal tumor margins in oral squamous cell carcinoma

et al. 2020

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Background When the resected specimen is sent for intraoperative margin assessment, all margins are grossly checked, and selected margins undergo a frozen section (FS) examination. Therefore, there is a possibility of sampling error. This study evaluated the effectiveness of using toluidine blue (TB) as an intraoperative triage screening tool to detect positive mucosal margins of the resected specimens of oral squamous cell carcinoma (OSCC) and serve as a guide for FS sampling. Methods Surgical samples of 30 consecutive patients with biopsy-proven OSCC were included in the study. A total of 140 mucosal margins were analyzed intraoperatively by TB and FS, the results were compared with the final histopathology. Results Of the 140 examined mucosal tumor margins, 14 stained positives with TB, six were true-positives, eight were false-positives, and there were no false-negatives, as confirmed by final histopathology of the same margins. The diagnostic performance measures were sensitivity 100.0%; specificity 94.0%; positive predictive value (PPV) 42.9%; negative predictive value (NPV) 100.0%; and accuracy 94.3% (95% CI: 89.0–97.5%). For FS, there were three true-positives, three false-negatives, and no false-positives. The diagnostic performance measures were sensitivity 50.0%; specificity 100.0%; PPV 100.0%; NPV 97.8%; and accuracy 97.9% (95% CI: 93.9–99.6%). Conclusion TB is less specific but more sensitive than FS for detecting positive mucosal margins of resected OSCC. Screening the tumor mucosal margins with TB before FS sampling may help identify more tumor-bearing margins. Trial registration This trial was registered at ClinicalTrials.gov. Registration number: NCT03554967. Registration date: June 13, 2018.

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A novel integrated platform for the identification of surgical margins in oral squamous cell carcinoma: results from a prospective single-institution series

Cited by 5 publications

References 34 publications

Intraoperative Techniques That Define the Mucosal Margins of Oral Cancer In-Vivo: A Systematic Review

Intraoperative Techniques That Define the Mucosal Margins of Oral Cancer In-Vivo: A Systematic Review

Targeting Immune-Related Biological Processes in Solid Tumors: We do Need Biomarkers

Toluidine blue versus frozen section for assessment of mucosal tumor margins in oral squamous cell carcinoma

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