Open Access
CC BY-NC-ND 4.0 · Laryngorhinootologie 2021; 100(S 02): S31
DOI: 10.1055/s-0041-1727677
Abstracts
Surgical assistance procedures

Intraoperative Free Margins Assessment of Oropharyngeal Squamous Cell Carcinoma with Confocal Laser Endomicroscopy: A Pilot Study

M Goncalves
1   Uniklinik RWTH Aachen, Klinik für Hals-, Nasen-, Ohrenheilkunde und Plastische Kopf- und Halschirurgie, Aachen
,
F Stelzle
2   Universitätsklinikum Erlangen, Mund-, Kiefer- und Gesichtschirurgischen Klinik, Erlangen
,
M Aubreville
3   Technische Hochschule Ingolstadt, Bildverstehen und medizinische Anwendung der künstlichen Intelligenz, Ingolstadt
,
SK Mueller
4   Universitätsklinikum Erlangen, Hals-Nasen-Ohren-Klinik, Erlangen
,
M Eckstein
5   Universitätsklinikum Erlangen, Pathologie, Erlangen
,
N Oetter
2   Universitätsklinikum Erlangen, Mund-, Kiefer- und Gesichtschirurgischen Klinik, Erlangen
,
A Maier
6   Technische Fakultät der Friedrich-Alexander Universität Erlangen-Nürnberg, Pattern Recognition Lab, Erlangen
,
H Iro
4   Universitätsklinikum Erlangen, Hals-Nasen-Ohren-Klinik, Erlangen
,
M Sievert
4   Universitätsklinikum Erlangen, Hals-Nasen-Ohren-Klinik, Erlangen
› Author Affiliations
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    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 12809 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 % , 77 % , 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 tumor margin.

    Poster-PDF A-1572.pdf

    Deutsche Forschungsgemeinschaft (GO 3182/2-1, MA 4898/17-1, OE 743/1- 1, STE 1877/7-1)


     

    Conflict of interest

    Der Erstautor gibt keinen Interessenskonflikt an.

    Address for correspondence

    Priv.-Doz. Dr. med. Goncalves Miguel
    Uniklinik RWTH Aachen, Klinik für Hals-, Nasen-, Ohrenheilkunde und Plastische Kopf- und Halschirurgie
    Universitätsklinikum Aachen, Pauwelsstraße 30
    52074 Aachen

    Publication History

    Article published online:
    13 May 2021

    © 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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