SCIEN and EE292E present "Fluorescence Guided Precision Surgery TM – Illuminating Tumors and Nerves"
Although treatment algorithms vary, surgery is the primary treatment modality for most solid cancers. In oncologic tumor resection, the preferred outcome is complete cancer removal as residual tumor left behind is considered treatment failure. However complete tumor removal needs to be balanced with functional preservation and minimizing patient morbidity including prevention of inadvertent nerve injury. The inability of surgeons to visually distinguish between tumor and normal tissue including nerves leads to residual cancer cells being left behind at the edges of resection, i.e. positive surgical margins (PSM). PSM can be as high as 20-40% in breast cancer lumpectomy, 21% for radical prostatectomy, and 13% for HNSCC. Similarly, using white light reflectance alone which is the current standard of care in operating rooms, nerve dysfunction following surgery has been reported to be as high as ~2-40% ranging from immediate post op to long-term dysfunction.
Molecular imaging with fluorescence provides enhanced visual definition between diseased and normal tissue and have been shown to decrease PSM in both animal models and patients. Molecular imaging with fluorescence can also provide enhanced visualization of important structures such as nerves to improve preservation and minimize inadvertent injury. Our laboratory has extensive experience in development of both nerve and tumor injectable markers for surgical visualization. In presentation we will discuss the development of nerve and tumor markers combinations to improve intraoperative visualization – aka Precision Surgery TM.
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