| Autor: |
de Kleijn BJ; Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, 6225 GA Nijmegen, The Netherlands., Heldens GTN; Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, 6225 GA Nijmegen, The Netherlands., Herruer JM; Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, 6225 GA Nijmegen, The Netherlands., Sier CFM; Department of Oncologic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands., Piazza C; Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy., de Bree R; Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands., Guntinas-Lichius O; Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany., Kowalski LP; Department of Head and Neck Surgery, University of Sao Paulo Medical School, Sao Paulo 01509, Brazil.; Department of Head and Neck Surgery and Otorhinolaryngology, AC Camargo Cancer Center, Sao Paulo 01509, Brazil., Vander Poorten V; Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.; Department of Oncology, Section Head and Neck Oncology, KU Leuven, 3000 Leuven, Belgium., Rodrigo JP; Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, 33011 Oviedo, Spain., Zidar N; Institute of Pathology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia., Nathan CA; Department of Otolaryngology-Head and Neck Surgery, Louisiana State University-Health Shreveport, Shreveport, LA 71101, USA., Tsang RK; Department of Otolaryngology-Head and Neck Surgery, National University of Singapore, Level 7 Tower Block, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore., Golusinski P; Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, 65-417 Zielona Gora, Poland., Shaha AR; Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA., Ferlito A; Coordinator of the International Head and Neck Scientific Group, 35122 Padua, Italy., Takes RP; Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, 6225 GA Nijmegen, The Netherlands. |
| Abstrakt: |
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. |
