Improving oral cancer surgery by objective intraoperative assessment of resection margins: a new era.

PURPOSE OF REVIEW: Achieving adequate resection margins (i.e., ≥5 mm of healthy tissue surrounding the tumor) in oral cavity squamous cell carcinoma (OCSCC) is difficult. This review discusses recent developments to guide surgical resection. It highlights the transition from the subjective conventional approaches to emerging, objective photonics-based methods.

RECENT FINDINGS: Specimen-driven intraoperative assessment of resection margins (IOARM) has significantly improved surgical outcomes. However, IOARM is subjective; moreover, it lacks widespread adoption due to reliance on a dedicated team of specialists. Raman spectroscopy is an objective, fast, nondestructive, and label-free technique that is suitable for IOARM. The latest Raman-based prototype demonstrates high precision.

SUMMARY: Integrating Raman-guided IOARM into the surgical-pathological workflow offers a practical, scalable approach to real-time, objective margin assessment, thereby improving patient outcomes.