Intraoperative free margins assessment of oropharyngeal squamous cell carcinoma with confocal laser endomicroscopy: a pilot study

Sievert M, Stelzle F, Aubreville M, Mueller SK, Eckstein M, Oetter N, Maier A, Mantsopoulos K, Iro H, Goncalves M (2021)

Publication Type: Journal article

Publication year: 2021

Journal

European Archives of Oto-Rhino-Laryngology Springer

DOI: 10.1007/s00405-021-06659-y

Abstract

Purpose: This pilot study aimed to assess the feasibility of intraoperative assessment of safe margins with confocal laser endomicroscopy (CLE) during oropharyngeal squamous cell carcinoma (OPSCC) surgery. Methods: We included five consecutive patients confirmed OPSCC and planned tumor resection in September and October 2020. Healthy appearing mucosa in the marginal zone, and the tumor margin, were examined with CLE and biopsy during tumor resection. A total of 12,809 CLE frames were correlated with the gold standard of hematoxylin and eosin staining. Three head and neck surgeons and one pathologist were asked to identify carcinoma in a sample of 169 representative images, blinded to the histological results. Results: Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. CLE optical biopsy of OPSCC demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, PPV, and NPV of 86%, 90%, 79%, 88%, and 82%, respectively, with inter-rater reliability and κ-value of 0.60. Conclusion: CLE can be easily integrated into the intraoperative setting, generate real-time, in-vivo microscopic images of the oropharynx for evaluation and demarcation of cancer. It can eventually contribute to a less radical approach by enabling a more precise evaluation of the cancer margin.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Florian Stelzle Department of Oral and Cranio-Maxillofacial Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Markus Eckstein Institute of Pathology Nicolai Oetter Department of Oral and Cranio-Maxillofacial Surgery Andreas Maier Lehrstuhl für Informatik 5 (Mustererkennung) Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Miguel Goncalves Department of Otorhinolaryngology – Head and Neck Surgery

Involved external institutions

Technische Hochschule Ingolstadt

Germany (DE)

How to cite

APA:

Sievert, M., Stelzle, F., Aubreville, M., Mueller, S.K., Eckstein, M., Oetter, N.,... Goncalves, M. (2021). Intraoperative free margins assessment of oropharyngeal squamous cell carcinoma with confocal laser endomicroscopy: a pilot study. European Archives of Oto-Rhino-Laryngology. https://dx.doi.org/10.1007/s00405-021-06659-y

MLA:

Sievert, Matti, et al. "Intraoperative free margins assessment of oropharyngeal squamous cell carcinoma with confocal laser endomicroscopy: a pilot study." European Archives of Oto-Rhino-Laryngology (2021).

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