Author:
Winnand Philipp,Ooms Mark,Heitzer Marius,Vohl Nils,Lammert Matthias,Hölzle Frank,Boernsen K. Olaf,Modabber Ali
Abstract
Abstract
Objectives
Inadequate resection margins of less than 5 mm impair local tumor control. This weak point in oncological safety is exacerbated in bone-infiltrating tumors because rapid bone analysis procedures do not exist. This study aims to assess the bony resection margin status of bone-invasive oral cancer using laser-induced breakdown spectroscopy (LIBS).
Materials and methods
LIBS experiments were performed on natively lasered, tumor-infiltrated mandibular cross-sections from 10 patients. In total, 5,336 spectra were recorded at defined distances from the tumor border. Resection margins < 1 mm were defined as very close, from 1–5 mm as close, and > 5 mm as clear. The spectra were histologically validated. Based on the LIBS spectra, the discriminatory power of potassium (K) and soluble calcium (Ca) between bone-infiltrating tumor tissue and very close, close, and clear resection margins was determined.
Results
LIBS-derived electrolyte emission values of K and soluble Ca as well as histological parameters for bone neogenesis/fibrosis and lymphocyte/macrophage infiltrates differ significantly between bone-infiltrating tumor tissue spectra and healthy bone spectra from very close, close, and clear resection margins (p < 0.0001). Using LIBS, the transition from very close resection margins to bone-infiltrating tumor tissue can be determined with a sensitivity of 95.0%, and the transition from clear to close resection margins can be determined with a sensitivity of 85.3%.
Conclusions
LIBS can reliably determine the boundary of bone-infiltrating tumors and might provide an orientation for determining a clear resection margin.
Clinical relevance
LIBS could facilitate intraoperative decision-making and avoid inadequate resection margins in bone-invasive oral cancer.
Funder
Schäfersnolte-Gedächtnis-Stiftung Ministerium für Kultur und Wissenschaft des Landes Nordrhein-Westfalen
Universitätsklinikum RWTH Aachen
Publisher
Springer Science and Business Media LLC