IMPORTANCE: The prevalence of genetically altered cells in @entity5 has a negative influence on the locoregional recurrence rate and lowers survival. Fluorescence visualization (FV) can identify clinically occult, high-risk @entity75 by allowing health care professionals and surgeons to visualize and map occult disease. This process may improve overall survival by decreasing rates of locoregional recurrence. OBJECTIVE: To assess the efficacy of FV-guided surgery in reducing locoregional recurrence and improving overall survival. DESIGN, SETTING, AND @entity1 : A retrospective, case-control observational study was conducted on @entity1 registered at a single oral oncology clinic from September 1, 2004, to August 31, 2009. The study included 246 @entity1 18 years or older with a diagnosis of a high-grade lesion (severe @entity1141 or carcinoma in situ) or @entity957 of less than 4 cm who underwent curative surgical treatment with at least 1 follow-up visit. Among these @entity1 , 154 underwent surgery with FV guidance (FV group) and the other 92 underwent conventional surgery (control group). Demographic and lesional characteristics and outcomes were collected, and the key factors for the efficacy of FV-guided surgery were examined. Follow-up was completed on December 31, 2011, and data were analyzed from @entity4456 to November 30, 2013. MAIN OUTCOMES AND MEASURES: Local recurrence of @entity75 with a histologic grade of severe @entity1141 or higher, the presence of regional failure (ie, a metastatic lesion in the cervical lymph nodes), or disease-free survival after surgery. RESULTS: Among the 246 @entity1 included in the study (mean [SD] age, 60 [12] years; 108 @entity1 and 138 @entity1 ), 156 had @entity957 and 90 had high-grade lesions. There were no significant differences between the FV (n   =   154) and control (n   =   92) groups in age, smoking history, anatomical site of the lesion, @entity5 size, and previous @entity5 . Among the 156 @entity1 with @entity957 , the 92 @entity1 in the FV group showed significant reduction in the 3-year local recurrence rate, from 40.6% (26 of 64 @entity1 ) to 6.5% (6 of 92 @entity1 ) (P   <   .001). Among the 90 @entity1 with high-grade lesions, the 62 @entity1 in the FV group showed a reduction in local recurrence rate from 11 of 28 @entity1 (39.3%) to 5 of 62 @entity1 (8.1%) (P   <   .001). The data also indicated that, compared with conventional surgery, the FV-guided approach for @entity957 was associated with less regional failure (14 of 92 @entity1 [15.2%] vs 16 of 64 [25.0%]; P   =   .08) and @entity204 (12 of 92 @entity1 [13.0%] vs 13 of 64 [20.3%]; P   =   .22), although these differences were not statistically significant. CONCLUSIONS AND RELEVANCE: In this study, the use of FV as part of the surgical margin decision process significantly reduced the rate of local recurrence in preinvasive high-grade and @entity5 . An ongoing multicenter, phase 3, randomized surgical trial has completed accrual, and the data will be used to validate the results of this study.

Fluorescence Visualization-Guided Surgery for Early-Stage XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'PARTICIPANTS', 'men'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'oral cancers', 'early-stage oral cancers', 'oral cancer'] @entity75 :: ('MESH:D001927', 'Disease') :: ['oral lesions'] @entity957 :: ('MESH:D002294', 'Disease') :: ['squamous cell carcinoma'] @entity4456 :: ('5580', 'Gene') :: ['May 1'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity5 :: (MESH:D009369,Disease) :: ['Oral Cancer']
