Although treatment algorithms vary, surgery is the primary treatment modality for most solid cancers. The fundamental goal of a curative oncologic surgery is complete cancer removal but equally important from the patient's point of view is function preservation and pain control. Currently, there is an increasing trend to adopt minimally invasive technologies such as endoscopic and robotic surgery in order to decrease patient morbidity. However, the ability for surgeons to distinguish between normal and diseased tissue by texture or consistency is significantly reduced with these techniques (due to lack of ability to physically touch the tissue) and is limited to visual inspection alone. Using white light reflectance which is the current standard mode of illumination in operating rooms, the visual difference between normal and cancerous tissue can be imperceptible. The inability of surgeons to visually distinguish between tumor and normal tissue leads to residual cancer cells left behind at the edges of resection, i.e. positive surgical margins and can be as high as 20-40% in breast cancer lumpectomy, 21% for radical prostatectomy, and 13% for HNSCC.
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 color-coded surgery.
Citation Format: Quyen T. Nguyen. Molecular navigation for cancer diagnosis and surgery: Imaging tumors and nerves [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; April 23-25, 2017; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2017;23(23_Suppl):Abstract nr IA15.