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. 2023 Oct 10;13(20):3161.
doi: 10.3390/diagnostics13203161.

Clinical Experience with Autofluorescence Guided Oral Squamous Cell Carcinoma Surgery

Petr Pošta  1 , Andreas Kolk  2 , Kristýna Pivovarčíková  3   4 , Jan Liška  1 , Jiří Genčur  1 , Omid Moztarzadeh  1   5 , Christos Micopulos  1 , Adam Pěnkava  1 , Maria Frolo  1 , Oliver Bissinger  2 , Lukáš Hauer  1
Affiliations

Clinical Experience with Autofluorescence Guided Oral Squamous Cell Carcinoma Surgery

Petr Pošta et al. Diagnostics (Basel). .

Abstract

In our study, the effect of the use of autofluorescence (Visually Enhanced Lesion Scope-VELscope) on increasing the success rate of surgical treatment in oral squamous carcinoma (OSCC) was investigated. Our hypothesis was tested on a group of 122 patients suffering from OSCC, randomized into a study and a control group enrolled in our study after meeting the inclusion criteria. The preoperative checkup via VELscope, accompanied by the marking of the range of a loss of fluorescence in the study group, was performed before the surgery. We developed a unique mucosal tattoo marking technique for this purpose. The histopathological results after surgical treatment, i.e., the margin status, were then compared. In the study group, we achieved pathological free margin (pFM) in 55 patients, pathological close margin (pCM) in 6 cases, and we encountered no cases of pathological positive margin (pPM) in the mucosal layer. In comparison, the control group results revealed pPM in 7 cases, pCM in 14 cases, and pFM in 40 of all cases in the mucosal layer. This study demonstrated that preoperative autofluorescence assessment of the mucosal surroundings of OSCC increased the ability to achieve pFM resection 4.8 times in terms of lateral margins.

Keywords: autofluorescence; margin status; oral squamous cell carcinoma; surgical treatment.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision.

Figures

Chart 1
Chart 1
Trend of incidence and mortality in the Czech Republic for diagnosis C00-C14, C30-C31 per 100,000.
Figure 1
Figure 1
Optical examination of the oral mucosa affected by the tumor. (a) barely visible invasive OSCC of the palato-alveolar area under white light; (b) clearly visible loss of fluorescence of the affected area; (c) transient marking of the extent of fluorescence loss. (d) barely visible invasive OSCC of the right lingual margin under white light; (e) clearly visible loss of fluorescence of the affected area; (f) transient marking of the extent of fluorescence loss.
Figure 2
Figure 2
Permanent marking of loss of fluorescence by electrocoagulation and tattoo technique. (a) invasive carcinoma of the soft and hard palate on the right side, visible loss of fluorescence using the VELscope; (b) the same situation with electrocoagulation marking; (c) a larger syringe filled with a small amount of dye, insulin syringes filled with tattoo ink; (d) tattoos of different colors indicating the loss of fluorescence around the carcinoma of the lower alveolar region for immediate and accurate orientation of the sample.
Chart 2
Chart 2
A box and whisker plot diagram showing the age distribution in both groups. Average marked with a + sign.
Chart 3
Chart 3
Mucosal margin status. Color meaning: red—MpFM, blue—MpCM, green—MpPM.
Chart 4
Chart 4
Deep margin status. Color meaning: red—BpFM, blue—BpCM, green—BpPM.
See this image and copyright information in PMC

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