Resección guiada por fluorescencia en pacientes con cáncer de lengua

Abstract

Background

Fluorescence has been successfully used as screening method of oral cavity cancer. In addition to the conventional oral examination, it identifies areas with histological changes that are not identified with conventional white light.

Objective

To determine whether fluorescence facilitates resection with negative margins in patients diagnosed with squamous cell carcinoma of the tongue.

Material and methods

Patients diagnosed with invasive tongue squamous cell carcinoma were evaluated with a conventional oral examination and fluorescence. To determine whether the threshold of injury coincided in both tests, the limits of section were identified and histologically evaluated.

Results

The study included 30 patients, 18 women and 12 men; 10 T1, 15 T2, and 5 patients with T3. The neoplastic margin evaluated with conventional light coincided with fluorescence in 17 patients (56%), and in 13 (44%) fluorescence identified a larger tumour. Surgical margins were negative in 27 (90%), and 3 (10%) positives that were all in the tongue thickness and with bulky tumours (T3).

Conclusions

Fluorescence identifies larger tumours than those identified with conventional oral examination in 44% of patients, and ensures a longer surgical resection with free surgical margins in 90% of cases. Submucosal and muscular invasion is not detected by this method.