Fluorescence-Guided Surgery for Assessing Margins in Head and Neck Cancer

Currently, there are several clinical trials investigating FGS to improve margin clearance in HNSCC, with many fluorescent agents already approved for use in other cancer types. As additional agents are brought into clinical use, it will be critical to understand how this technique will or will not improve oncological management in our patients. To address this important point, we present 2 key areas where surgeons will consider use of these FGS: to assess the peripheral mucosal margin and the deep surface of the tumor. We outline how in vivo and ex vivo fluorescence can be used for this purpose. We summarize data from multiple sources to explain how FGS is most likely to help with deep margin clearance.