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Abstract

Adequate resection of oral cavity squamous cell carcinoma (OCSCC) means complete tumor removal with a clear margin of more than 5 mm. For OCSCC, 85% of the surgical resections appear inadequate. Raman spectroscopy is an objective and fast tool that can provide real-time information about the molecular composition of tissue and has the potential to provide an objective and fast intraoperative assessment of the entire resection surface. A previous study demonstrated that OCSCC can be discriminated from healthy surrounding tissue based on the higher water concentration in tumor. In this study, we investigated how the water concentration changes across the tumor border toward the healthy surrounding tissue on freshly excised specimens from the oral cavity. Experiments were performed on tissue sections from 20 patients undergoing surgery for OCSCC. A transition from a high to a lower water concentration, from tumor (76% ± 8% of water) toward healthy surrounding tissue (54% ± 24% of water), takes place over a distance of about 4 to 6 mm across the tumor border. This was accompanied by an increase of the heterogeneity of the water concentration in the surrounding healthy tissue. The water concentration distributions between the regions were significantly different (P < 0.0001). This new finding highlights the potential of Raman spectroscopy for objective intraoperative assessment of the resection margins.  

Author information​

Barroso EM1, Smits RW2, van Lanschot CG2, Caspers PJ3, Ten Hove I1, Mast H1, Sewnaik A2, Hardillo JA2, Meeuwis CA2, Verdijk R4, Noordhoek Hegt V4, Baatenburg de Jong RJ2, Wolvius EB1, Bakker Schut TC5, Koljenović S4, Puppels GJ3.

1Department of Oral & Maxillofacial Surgery, Special Dental Care, and Orthodontics, Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.

2Department of Otorhinolaryngology & Head and Neck Surgery, Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.

3Center for Optical Diagnostics & Therapy, Department of Dermatology, Cancer Institute, Erasmus MC, Rotterdam, The Netherlands. RiverD International BV, Rotterdam, The Netherlands.

4Department of Pathology, Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.

5Center for Optical Diagnostics & Therapy, Department of Dermatology, Cancer Institute, Erasmus MC, Rotterdam, The Netherlands. RiverD International BV, Rotterdam, The Netherlands. t.bakkerschut@erasmusmc.nl.