Applicability of autofluorescence and fluorescent probes in early detection of oral potentially malignant disorders: a systematic review and meta-data analysis

Fluorescence Visualization-Guided Surgery Improves Local Control for Mandibular Squamous Cell Carcinoma

BACKGROUND

Local recurrence is common in mandibular squamous cell carcinoma (MSCC). Fluorescence visualization is a noninvasive technology that can detect oral epithelial dysplasia around MSCC, and it can potentially reduce local recurrence.

PURPOSE

The purpose of this study was to measure and compare local control (LC) between fluorescence visualization-guided surgery (FVS) and conventional surgery for patients with Stages I or II MSCC.

STUDY DESIGN, SETTING, SAMPLE

This retrospective cohort study was conducted at Tokyo Dental College, Chiba Hospital, or Chiba Dental Center. The medical records of MSCC patients from 2000 to 2021 were analyzed. Patients from any sex and 18 years of age or older with complete records who received surgery for mandibular SCC in the early stages were included in this study.

PREDICTOR VARIABLE

The predictor variable was operative treatment and was divided into 2 groups, conventional or FVS.

MAIN OUTCOME VARIABLES

The outcome variable is 5-year LC defined as no recurrence at or within 20 mm of the surgical site.

COVARIATES

Covariates included demographic variables of age, sex, clinical and pathological characteristics, forms of resection, lifestyle, and quality of life.

ANALYSES

Data analysis was performed by carrying out χ2 tests. Survival outcome was performed by the Kaplan-Meier method, which was used to calculate and stratify the log-rank test; P values <.05 indicated statistical significance.

RESULTS

This study sample was composed of 56 subjects with a mean age of 68.5 years old (standard deviation 13.7), and 33 (58.9%) were female. There were 36 (64.3%) and 20 (35.7%) subjects in the conventional and FVS groups. The characteristics and quality of life did not differ significantly between the 2 groups. Five-year LC with FVS was statistically significantly higher than conventional surgery (P = .04, 94.4 vs 77.2%). Multivariate analysis for LC rate only identified FVS (P = .004; hazard ratio = 0.11, 95% confidence interval = 0.46, 0.88).

CONCLUSION AND RELEVANCE

On MSCC, LC was 94.4% in FVS versus 77.2% in conventional surgery. For MSCC at stages I and II, FVS was associated with improved LC.

Personalized Medicine in Oral Oncology: Imaging Methods and Biological Markers to Support Diagnosis of Oral Squamous Cell Carcinoma (OSCC): A Narrative Literature Review

For decades, oral squamous cell carcinoma (OSCC) has been one of the most prevalent and mortal cancers worldwide. The gold standard for OSCC diagnosis is still histopathology but this narrative multidisciplinary review has the aim to explore the literature about conventional OSCC prognostic indicators related to the pTNM stage at the diagnosis such as the depth of invasion and the lymphovascular invasion associated with distant metastasis as indicators of poor life expectancy. Despite its multifactorial nature and recognizable precursors, its diagnosis at the early stages is still challenging. We wanted to highlight the importance of the screening as a primary weapon that a stomatologist should consider, intercepting all at-risk conditions and lesions associated with OSCC and its early stages. This narrative review also overviews the most promising imaging techniques, such as CT, MRI, and US-echography, and their application related to clinical and surgical practice, but also the most-investigated prognostic and diagnostic tissue and salivary biomarkers helpful in OSCC diagnosis and prognostic assessment. Our work highlighted remarkable potential biomarkers that could have a leading role in the future. However, we are still far from defining an appropriate and concrete protocol to apply in clinical practice. The hope is that the present and future research will overcome these limitations to benefit patients, clinicians, and welfare.

Applicability of autofluorescence and fluorescent probes in the trans-surgical of oral carcinomas: A systematic review

Oral cancer represents an important health problem, as it is the sixth most common type of cancer in the world and is associated with high rates of morbidity and mortality. The treatment considered the gold standard for this type of tumor is surgical resection with negative margins, with a distance of at least 5 mm from the tumor. This procedure is strongly associated with local control and disease-specific survival, however, in many cases, large amounts of healthy tissue are removed, resulting in surgical defects, compromising various functions and directly affecting the individual's quality of life. From this perspective, this systematic review aimed to evaluate the use of autofluorescence and fluorescent probes as potential adjuvant techniques to facilitate the delineation of surgical margins for oral cancers. A comprehensive search was performed in Pubmed, Scopus, Web of Science, LIVIVO, Embase, ProQuest Open Access Dissertations & Theses, Open Access Theses and Dissertations, and DART Europe databases, where 1948 articles were found. After the different stages of critical evaluation, 15 articles were selected, eligible for the inclusion criteria. Of these, 7 articles used autofluorescence, 7 used fluorescent probes and 1 article used both methods. As for autofluorescence, the most used device was the VELScope, and indocyanine green was the most used probe. Compared to histopathology, autofluorescence did not obtain significant and/or superiors results. In contrast to fluorescent probes that, most articles showed a good performance of margins during surgical resection, making them a promising alternative. However, it is still necessary to carry out the analysis of more articles, with more significant samples and sensitivity and specificity data to qualify the results.