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Simple Summary: Oral cavity is the most common site of head and neck cancer which is ranked as the eighth most common cancer worldwide. Oral cancer treatment is often associated with significant morbidity and is sometimes ineffective. These cancers, mainly due to tobacco and alcohol consumption, can develop from oral potentially malignant disorders, the most common of which is oral leukoplakia. Some of these oral potentially malignant disorders disappear, while others will transform to oral cancer. Patients may also develop cancer in the field of cancerization. Unfortunately, except for the surgical excision of lesions with dysplasia, there is no effective intervention to effectively prevent transformation or cancer development in the field of cancerization. Moreover, no standardized biomarker has been clearly identified as sufficient to predict malignant transformation. In this article, several experts discuss the main challenges in oral cancer prevention, in particular the need (i) to define new a new classification system integrating cellular and molecular features aiming (ii) at better identifying patients at high risk of malignant transformation, and (iii) at developing treatment strategies to prevent their malignant transformation of oral potentially malignant disorders. Oral potentially malignant disorders (OPMD) may precede oral squamous cell carcinoma (OSCC). Reported rates of malignant transformation of OPMD range from 3 to 50%. While some clinical, histological, and molecular factors have been associated with a high-risk OPMD, they are, to date, insufficiently accurate for treatment decision-making. Moreover, this range highlights differences in the clinical definition of OPMD, variation in follow-up periods, and molecular and biological heterogeneity of OPMD. Finally, while treatment of OPMD may improve outcome, standard therapy has been shown to be ineffective to prevent OSCC development in patients with OPMD. In this perspective paper, several experts discuss the main challenges in oral cancer prevention, in particular the need to (i) to define an OPMD classification system by integrating new pathological and molecular characteristics, aiming (ii) to better identify OPMD at high risk of malignant transformation, and (iii) to develop treatment strategies to eradicate OPMD or prevent malignant transformation. [ABSTRACT FROM AUTHOR]

Although the potential of vibrational spectroscopy for biomedical applications has been well demonstrated, translation into clinical practice has been relatively slow. This Editorial assesses the challenges facing the field and the potential way forward. While many technological challenges have been addressed to date, considerable effort is still required to gain acceptance of the techniques among the medical community, standardise protocols, extend to a clinically relevant scale, and ultimately assess the health economics underlying clinical deployment. National and international research networks can contribute much to technology development and standardisation. Ultimately, large-scale funding is required to engage in clinical trials and instrument development. [ABSTRACT FROM AUTHOR]

An earlier and more accurate detection of (small) cancerous and precancerous lesions in the oral cavity is essential to improve the prognosis of oral squamous cell carcinomas. Raman spectroscopy is being pursued as a potential method to realize this improvement, since the technique provides objective information on a biochemical level and can be used for real-time guidance of the diagnostic procedure. Since oral mucosal tissue is inhomogeneous and comprises different layers and histological structures, a good understanding of the signal contributions of the individual layers and structures is required for an accurate interpretation of in vivo tissue spectra measurement volumes. The aim of this study was to create a standardized method to collect and analyse the spectral contributions of individual histopathological structures in oral mucosa. The method is based on Raman microspectroscopic mapping of unstained frozen tissue sections and subsequent histopathological annotation of the features in the resulting Raman images. The obtained annotated reference spectra were used as input in an unsupervised hierarchical cluster analysis in order to determine the spectral characteristics and variance within one histo(patho)logical structure. The described method resulted in an annotated database of Raman spectral characteristics of individual histopathological structures encountered in oral tissue. This database can be used as input for the development of classification and quantification algorithms, in order to achieve a high specificity and sensitivity for clinical diagnostic instruments. Additionally, this database can be used to optimize the exact location and measurement volume of in vivo measurements. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to investigate the potential of Raman spectroscopy for detection of oral cavity squamous cell carcinoma (OCSCC) in bone resection surfaces during mandibulectomy. Materials & methods Raman mapping experiments were performed on fresh mandible resection specimens from patients treated with mandibulectomy for OCSCC. A tumour detection algorithm was created based on water concentration and the high-wavenumber range (2800 cm −1 –3050 cm −1 ) of the Raman spectra. Results Twenty-six ex vivo Raman mapping experiments were performed on 26 fresh mandible resection specimens obtained from 22 patients. The algorithm was applied on an independent test set and showed an accuracy of 95%, a sensitivity of 95%, and a specificity of 87%. Conclusion These results form the basis for further development of a Raman spectroscopy tool as an objective method for intraoperative assessment of bone resection margins. [ABSTRACT FROM AUTHOR]

Background: Currently, up to 85% of the oral resection specimens have inadequate resection margins, of which the majority is located in the deeper soft tissue layers. The prognosis of patients with oral cavity squamous cell carcinoma (OCSCC) of the tongue is negatively affected by these inadequate surgical resections. Raman spectroscopy, an optical technique, can potentially be used for intra-operative evaluation of resection margins.Objective: To develop in vitro Raman spectroscopy-based tissue classification models that discriminate OCSCC of the tongue from (subepithelial) non-tumorous tissue.Materials and Methods: Tissue classification models were developed using Principal Components Analysis (PCA) followed by (hierarchical) Linear Discriminant Analysis ((h)LDA). The models were based on a training set of 720 histopathologically annotated Raman spectra, obtained from 25 tongue samples (11 OCSCC and 14 normal) of 10 patients, and were validated by means of an independent validation set of 367 spectra, obtained from 19 tongue samples (6 OCSCC and 13 normal) of 11 patients.Results: A PCA-LDA tissue classification model 'tumor' versus 'non-tumorous tissue' (i.e. surface squamous epithelium, connective tissue, muscle, adipose tissue, gland and nerve) showed an accuracy of 86% (sensitivity: 100%, specificity: 66%). A two-step PCA-hLDA tissue classification model 'tumor' versus 'non-tumorous tissue' showed an accuracy of 91% (sensitivity: 100%, specificity: 78%).Conclusion: An accurate PCA-hLDA Raman spectroscopy-based tissue classification model for discrimination between OCSCC and (especially the subepithelial) non-tumorous tongue tissue was developed and validated. This model with high sensitivity and specificity may prove to be very helpful to detect tumor in the resection margins. [ABSTRACT FROM AUTHOR]