A novel integrated platform for the identification of surgical margins in oral squamous cell carcinoma: results from a prospective single-institution series

Abstract

Abstract Background The optimal surgical margins assessment is capital in oral squamous cell carcinoma (OSCC) management. We evaluated the clinical benefits of integrating intraoperative macroscopic margin (MM) assessment and narrow band imaging (NBI). Methods Sixteen OSCC patients eligible for surgery were prospectively enrolled. For each patient, 2 to 6 bioptic samples of MM and NBI margins were obtained and histologically analyzed for the presence of dysplasia and lymphocytes. Microvessel density was investigated by CD34 immunohistochemistry. Results Taken together, 104 specimens were analyzed, including 15% tumors, 33% MM, 33% NBI margins, and 19% MM-NBI overlapping margins. The NBI margins were closer to the lesion in 50% cases, while the same number of MM were more conservative than NBI, irrespective of the tumor site. The rate of histologically positive margins was similar among the two methods, akin to the microvessel density. Conclusions MM assessment should be integrated but not replaced with the NBI technology to allow for more conservative surgery.

Keywords

• Oral squamous cell carcinoma
• NBI
• Narrow band imaging
• Microvascular density
• Surgical margins