Assessment of the bony resection margin distance in bone-invasive oral cancer using laser-induced breakdown spectroscopy

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.

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1436-3771

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English

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Yes

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Published

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Peer review of the complete publication

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Hybrid

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Winnand, P., Ooms, M., Heitzer, M., Vohl, N., Lammert, M., Hölzle, F., Börnsen, K. O., & Modabber, A. (2024). Assessment of the bony resection margin distance in bone-invasive oral cancer using laser-induced breakdown spectroscopy. Clinical Oral Investigations, 28. https://doi.org/10.1007/s00784-024-05862-5

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