Study aims to improve oral cancer surgery outcomes

The Terry Fox Research Institute (TFRI) in Vancouver has launched a $4.7 million Pan-Canadian clinical trial aimed at improving outcomes for patients undergoing surgery for oral squamous cell cancers -- the Canadian Optically Guided Approach for Oral Lesions Surgical (COOLS) trial.

Currently, about 30% of patients who receive oral surgery have their cancer recur, but this trial will test a new approach that the researchers hope will change this percentage.

Using a new surgical approach guided by an existing handheld light tool, the surgeons, pathologists, and scientists involved in this nine-center study will determine whether recurrence is reduced when they shift the surgical field for the removal of tumors or precancerous cells in the mouth.

The surgeons will use fluorescence visualization (FV) or "blue light" provided by the optical aid rather than traditional white light to determine the tissue to be removed. Under the blue light, normal tissue generates a fluorescence that is absent in tumors or precancerous tissue. The study will aim to spare normal healthy tissue from surgery while catching high-risk, precancerous tissue identified through FV, according to the institute.

"In work we've conducted to date in Vancouver, there has been almost no recurrence where surgery followed the contour of the lesion shown by using FV-guided surgery," said principal investigator Catherine Poh, PhD, a senior scientist with the British Columbia Cancer Agency, in a press release. 'Working together with surgeons, pathologists, research staff, and scientists, this TFRI-funded study will enable us to test the approach on a broader cohort of patients at sites across the country and obtain the evidence required to change current practice."

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