Intraoperative Imaging Techniques to Improve Surgical Resection Margins of Oropharyngeal Squamous Cell Cancer: A Comprehensive Review of Current Literature

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art_KLEIJN_Intraoperative_Imaging_Techniques_to_Improve_Surgical_Resection_Margins_.PDF (884.15 KB)
Citações na Scopus
6
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
MDPI
Autores
KLEIJN, Bertram J. de
HELDENS, Gijs T. N.
HERRUER, Jasmijn M.
SIER, Cornelis F. M.
PIAZZA, Cesare
BREE, Remco de
GUNTINAS-LICHIUS, Orlando
POORTEN, Vincent Vander
RODRIGO, Juan P.
Citação
CANCERS, v.15, n.3, article ID 896, 25p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Simple Summary In head and neck cancer, there are several treatment options. When surgical treatment is chosen, removal of the entire tumor is necessary for optimal therapy of the patient. This, however, is challenging in vulnerable areas of the body such as the mouth and throat, as a more radical resection leads to more severe functional limitations after surgery. Several imaging techniques facilitate the distinction of tumor versus adjacent healthy tissue during the operation, which can help the surgeon remove the entire tumor with optimal functional outcomes. In this paper, we aim to provide an overview of these imaging techniques applicable to oropharyngeal squamous cell carcinoma and discuss the possibilities for optimizing the surgical outcome of patients. 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 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.
Palavras-chave
intraoperative imaging, narrow band imaging, high resolution microendoscopic imaging, confocal laser endomicroscopy, ultrasound, (auto) fluorescence imaging, augmented reality, transoral surgery, frozen section analysis, computed tomography
URI
https://observatorio.fm.usp.br/handle/OPI/52805
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/28
Artigos e Materiais de Revistas Científicas - ODS/03