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Background/Objectives: Oral cancer ranks among the top ten cancers globally, with a five-year survival rate below 50%. This study aimed to evaluate the effectiveness of autofluorescence-guided surgery compared to standard surgical methods in identifying tumor-free margins and ensuring complete excision. Methods: A prospective cohort of 80 patients was randomized into two groups: the control group underwent excision with a 10 mm margin based on clinical judgment, while the experimental group used autofluorescence guidance with a 5 mm margin beyond fluorescence visualization loss. Autofluorescence imaging was performed using the OralID device, which employs a 405 nm excitation laser to detect abnormal tissue. Ethical approval was obtained from the “Spitalul Clinic Municipal de Urgență Timișoara” Ethics Committee (approval number 08/26.02.2021), and the trial was registered at the University of Medicine and Pharmacy Timisoara (trial no. 59/25.11.2021). A double analysis was conducted: a primary analysis of the full cohort and a subgroup analysis focusing on squamous cell carcinoma (control: n = 19; experimental: n = 24). Histopathological analysis was the gold standard for margin evaluation, with margins coded as tumor-free margins (0), close (1), or infiltrated (2). Results: Statistically significant differences were observed in tumor-free margins between the control (73.17%) and experimental (97%) groups (p = 0.003). Subgroup analysis for SCC showed no significant difference (control: 84.21%; experimental: 95.83%; p = 0.306). Tumor location also differed significantly (p = 0.011), while other baseline variables, such as tumor type and patient characteristics, showed no significant differences. Conclusions: Autofluorescence-guided surgery improves the detection of tumor-free margins and may serve as an effective adjunct in oral cancer management. Larger studies are recommended to confirm these findings.
Background/Objectives: Oral cancer ranks among the top ten cancers globally, with a five-year survival rate below 50%. This study aimed to evaluate the effectiveness of autofluorescence-guided surgery compared to standard surgical methods in identifying tumor-free margins and ensuring complete excision. Methods: A prospective cohort of 80 patients was randomized into two groups: the control group underwent excision with a 10 mm margin based on clinical judgment, while the experimental group used autofluorescence guidance with a 5 mm margin beyond fluorescence visualization loss. Autofluorescence imaging was performed using the OralID device, which employs a 405 nm excitation laser to detect abnormal tissue. Ethical approval was obtained from the “Spitalul Clinic Municipal de Urgență Timișoara” Ethics Committee (approval number 08/26.02.2021), and the trial was registered at the University of Medicine and Pharmacy Timisoara (trial no. 59/25.11.2021). A double analysis was conducted: a primary analysis of the full cohort and a subgroup analysis focusing on squamous cell carcinoma (control: n = 19; experimental: n = 24). Histopathological analysis was the gold standard for margin evaluation, with margins coded as tumor-free margins (0), close (1), or infiltrated (2). Results: Statistically significant differences were observed in tumor-free margins between the control (73.17%) and experimental (97%) groups (p = 0.003). Subgroup analysis for SCC showed no significant difference (control: 84.21%; experimental: 95.83%; p = 0.306). Tumor location also differed significantly (p = 0.011), while other baseline variables, such as tumor type and patient characteristics, showed no significant differences. Conclusions: Autofluorescence-guided surgery improves the detection of tumor-free margins and may serve as an effective adjunct in oral cancer management. Larger studies are recommended to confirm these findings.
Aim: To assess the risk of developing oral cancer (OC) in individuals who have diabetes mellitus (DM) and to predict the prognosis for OC patients with DM. Methodology: The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines and was registered in PROSPERO (CRD42024517197). A thorough search of databases was conducted from January 2000 to May 2024 to identify studies reporting the reporting association between DM and the development of OC. Quality assessment was performed using the Newcastle Ottawa Scale for included studies. The odds ratio (OR) and risk ratio (RR) served as the summary statistic measure, employing a random-effect model with a significance threshold set at P < 0.05. Results: Twelve studies met the eligibility criteria and underwent qualitative synthesis, with eight studies in meta-analysis. Upon quality assessment, the studies demonstrated a range of moderate to low risk of bias (ROB), ensuring a comprehensive evaluation of the evidence base. Meta-analysis showed that individuals with type 2 diabetes mellitus had a higher shown high association (OR = 2.07 (0.52–8.18) and risk (RR =1.31 (0.70–2.43) for the development of OC compared to nondiabetics (P > 0.05). The funnel plot did show presence of possible publication bias in meta-analysis. Conclusion: It was found that DM patients were at higher risk and more associated with the development of OC. However, as OC is multifactorial disease, the presence of a single factor cannot have a significant effect on disease progression. Therefore, furthermore prospective studies with a greater sample size and follow-up period should be conducted so as to validate the findings of this study.
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