Usefulness of fluorescence visualization-guided surgery for early-stage tongue squamous cell carcinoma compared to iodin
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ORIGINAL ARTICLE
Usefulness of fluorescence visualization‑guided surgery for early‑stage tongue squamous cell carcinoma compared to iodine vital staining Yusuke Ikeda1 · Taiki Suzuki1 · Hirokazu Saitou1 · Satoru Ogane2 · Kazuhiko Hashimoto3 · Nobuo Takano2 · Takeshi Nomura1 Received: 30 March 2020 / Accepted: 14 May 2020 © The Author(s) 2020
Abstract Background In the most cases of oral squamous cell carcinoma (OSCC), oral epithelial dysplasia (OED) is found adjacent to the primary tumor. The delineation of surgical margins for OSCC is critical to minimize the risk for local recurrence. The aim of this study is to demonstrate that the fluorescence visualization (FV)- device can delineated the lesion visualizes OED of adjacent primary tumors by histopathologically comparison to conventional iodine vital staining. Material and methods The study involved 40 patients with superficial tongue squamous cell carcinoma treated from July 2016 to July 2018 at the Oral Cancer Center, Tokyo Dental College. Results Cytokeratin 13 (CK13) expression rate in the area of fluorescence visualization loss (FVL) was significantly lower than that in the area of fluorescence visualization retention (FVR). In addition, CK17, Ki-67, and p53 expression rates were significantly higher in FVL than FVR. There was no significant difference in the delineation rate or area between FVL and iodine-unstained area. High-grade dysplasia was observed most frequently at the FV and iodine-unstained boundary, but no significant pathological differences were found. Conclusion We strongly suggest the FV-guided surgery is a useful method for accurate resection in early-stage tongue squamous cell carcinoma. Keywords Fluorescence visualization · FV-guided surgery · Iodine vital staining · OSCC · Tongue cancer · Surgical resection
Introduction Oral squamous cell carcinoma (OSCC) is the cancer with the sixth highest mortality rate worldwide, and the survival rate is low. The five-year survival rates for stage 1 tongue cancer is 80%, while the five-year survival rates for cancers of oral cavities are around 50%. This is largely reflected by * Takeshi Nomura [email protected] 1
Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Ichikawa General Hospital, 5‑11‑13 Sugano, Ichikawa, Chiba 272‑8513, Japan
2
Oral Cancer Center, Tokyo Dental College, Ichikawa General Hospital, 5‑11‑13 Sugano, Ichikawa, Chiba 272‑8513, Japan
3
Division of Surgical Pathology, Clinical Laboratory, Ichikawa General Hospital, Tokyo Dental College, 5‑11‑13 Sugano, Ichikawa, Chiba 272‑8513, Japan
the fact that many cases are in advanced stages at the time of detection. [1] The conventional treatment for early OSCC is surgical resection or radiation therapy based on the National Comprehensive Cancer Network (NCCN) guidelines [2]. Surgical resection is given priority because it is generally regarded as effective [3]. Surgeons frequently place the surgical margin at 1.5–2.0 cm from the primary tumor based on a visibly abnormal field and palpa
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