Abstract 4603: Optically-guided surgical approach using fluorescence visualization can significantly improve locoregional recurrence and overall survival for early stage oral cancer
Bibliographic record
Abstract
Abstract Recurrence following excision of high-grade dysplasia (HGD, severe dysplasia and carcinoma in situ) or squamous cell carcinoma (SCC) implies that the presence of subclinical changes at the margins is not apparent at surgery, resulting in incomplete excision. Fluorescence visualization (FV) has shown its value in identifying clinically not apparent high-risk oral lesions. The objective of this study is to assess the effectiveness of FV-guided surgery in reducing the loco-regional recurrence and improving overall survival. Method: From September 1st 2004 to August 31, 2009, 264 consecutive patients diagnosed with T1/T2 SCC or HGD were registered at the BC Cancer Agency and treated with surgical excision with intent to cure. Among these, 246 patients (93%; SCC, 132; HGD, 114) had a follow-up period of at least 6 months. Among these patients, 149 had the surgery done under FV guidance (FV group) while the other 97 were treated with conventional surgery procedure (control group). The outcome measurements include pathology-proven local recurrence to severe dysplasia or higher requiring another surgical procedure, regional failure, and death at follow-up. Time to outcome curve was estimated by the Kaplan-Meier method. Results: There is no significant difference between FV and control groups in age, smoking habit, lesion anatomical site, diagnosis, tumor size, and previous cancer history. There were more females in the FV group (51% vs. 33%, P = 0.006). With an average of 40 months follow-up, the FV group shows significantly lower local recurrence (7% vs. 38%), regional failure (6% vs. 23%), and death (5% vs. 20%), and significant longer time to recurrence (P < 0.0001), regional failure (P = 0.0007), and death of disease (P = 0.004). Conclusion: Although they are retrospectively collected from a single centre, the data have strongly demonstrated that the use of FV for surgical margin decision can significantly improve outcomes of the early stage oral cancer. An on-going 5-year multi-centre phase III randomized surgical trial (the COOLS trial), funded by Terry Fox Research Institute, has started to recruit patients and the data will be used to validate the results of this study. (Supported by R01 DE17013 from the National Institute of Dental and Craniofacial Research, CCSRI-20336 from Canadian Cancer Society Research Institute, and TFRI-2009-24 from Terry Fox Research Institute. CFP is currently supported by a Scholar Award from the Michael Smith Foundation for Health Research). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4603. doi:1538-7445.AM2012-4603
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".