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Fluorescence Visualization-Guided Surgery Improves Local Control for Mandibular Squamous Cell Carcinoma.

Takamichi Morikawa1, Takahiko Shibahara2, Masayuki Takano3

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Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|September 7, 2024
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Summary

Fluorescence visualization-guided surgery (FVS) significantly improved local control (LC) for early-stage mandibular squamous cell carcinoma (MSCC). FVS achieved 94.4% LC compared to 77.2% with conventional surgery, reducing recurrence rates.

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Area of Science:

  • Oncology
  • Surgical Innovation
  • Oral Medicine

Background:

  • Local recurrence is a significant challenge in mandibular squamous cell carcinoma (MSCC).
  • Fluorescence visualization (FV) offers a noninvasive method to detect precancerous lesions around MSCC.
  • FV has the potential to decrease local recurrence rates in MSCC patients.

Purpose of the Study:

  • To compare local control (LC) rates between fluorescence visualization-guided surgery (FVS) and conventional surgery.
  • To evaluate the efficacy of FVS in reducing local recurrence for early-stage (Stages I and II) MSCC.

Main Methods:

  • A retrospective cohort study analyzed medical records of MSCC patients from 2000 to 2021.
  • Patients with early-stage MSCC who underwent either conventional surgery or FVS were included.
  • Local control was defined as no recurrence within 20 mm of the surgical site over 5 years.

Main Results:

  • The study included 56 patients (mean age 68.5 years, 58.9% female).
  • Five-year local control was significantly higher with FVS (94.4%) compared to conventional surgery (77.2%) (P=0.04).
  • Multivariate analysis confirmed FVS as a significant independent predictor of improved LC (P=0.004).

Conclusions:

  • Fluorescence visualization-guided surgery demonstrates superior local control for early-stage MSCC.
  • FVS is associated with a substantial reduction in local recurrence rates compared to conventional surgical approaches.
  • This technique holds promise for improving outcomes in patients with mandibular squamous cell carcinoma.