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Published on: October 20, 2010
Fluorescence Visualization-Guided Surgery Improves Local Control for Mandibular Squamous Cell Carcinoma
Takamichi Morikawa1, Takahiko Shibahara2, Masayuki Takano3
1Clinical Fellow, Oral and Maxillofacial Surgery, Mistuwadai General Hospital, Chiba-City, Chiba, Japan; Senior Assistant Professor, Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan.
Background:
Local recurrence is common in mandibular squamous cell carcinoma (MSCC). Fluorescence visualization is a noninvasive technology that can detect oral epithelial dysplasia around MSCC, and it can potentially reduce local recurrence.
Purpose:
The purpose of this study was to measure and compare local control (LC) between fluorescence visualization-guided surgery (FVS) and conventional surgery for patients with Stages I or II MSCC.
Study Design, Setting, Sample:
This retrospective cohort study was conducted at Tokyo Dental College, Chiba Hospital, or Chiba Dental Center. The medical records of MSCC patients from 2000 to 2021 were analyzed. Patients from any sex and 18 years of age or older with complete records who received surgery for mandibular SCC in the early stages were included in this study.
Predictor Variable:
The predictor variable was operative treatment and was divided into 2 groups, conventional or FVS.
Main Outcome Variables:
The outcome variable is 5-year LC defined as no recurrence at or within 20 mm of the surgical site.
Covariates:
Covariates included demographic variables of age, sex, clinical and pathological characteristics, forms of resection, lifestyle, and quality of life.
Analyses:
Data analysis was performed by carrying out χ2 tests. Survival outcome was performed by the Kaplan-Meier method, which was used to calculate and stratify the log-rank test; P values <.05 indicated statistical significance.
Results:
This study sample was composed of 56 subjects with a mean age of 68.5 years old (standard deviation 13.7), and 33 (58.9%) were female. There were 36 (64.3%) and 20 (35.7%) subjects in the conventional and FVS groups. The characteristics and quality of life did not differ significantly between the 2 groups. Five-year LC with FVS was statistically significantly higher than conventional surgery (P = .04, 94.4 vs 77.2%). Multivariate analysis for LC rate only identified FVS (P = .004; hazard ratio = 0.11, 95% confidence interval = 0.46, 0.88).
Conclusion And Relevance:
On MSCC, LC was 94.4% in FVS versus 77.2% in conventional surgery. For MSCC at stages I and II, FVS was associated with improved LC.
