title: Presurgical mapping of basal cell carcinoma or squamous cell carcinoma by confocal laser endomicroscopy compared to traditional micrographic surgery: a single-centre prospective feasibility study.
abstract: BACKGROUND
  At present, no ideal diagnostic tools exist in the market to excise cancer tissue with the required safety margins and to achieve optimal aesthetic results using tissue-conserving techniques.
  
  
  OBJECTIVE
  In this prospective study, confocal laser endomicroscopy (CLE) and the traditional gold standard of magnifying glasses (MG) were compared regarding the boundaries of in vivo basal cell carcinoma and squamous cell carcinoma.
  
  
  METHODS
  Tumour diameters defined by both methods were measured and compared with those determined by histopathological examination. Nineteen patients were included in the study.
  
  
  RESULTS
  The CLE technique was found to be superior to excisional margins based on MG only. Re-excision was required in 68% of the cases following excision based on MG evaluation, but only in 27% of the cases for whom excision margins were based on CLE.
  
  
  CONCLUSIONS
  Our results are promising regarding the distinction between tumour and healthy surrounding tissue, and indicate that presurgical mapping of basal cell carcinoma and squamous cell carcinoma is possible. The tool itself should be developed further with special attention to early detection of skin cancer.
authors.affiliation: Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schulz
authors.affiliation: Department of Neurosurgery.
authors.forename: Samira
authors.initials: S
authors.lastname: Daali
authors.affiliation: Department of Neurosurgery.
authors.forename: Mehreen
authors.initials: M
authors.lastname: Javed
authors.affiliation: Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke.
authors.forename: Paul Christian
authors.initials: PC
authors.lastname: Fuchs
authors.affiliation: Institute of Pathology, Cologne-Merheim Medical Center (CMMC), Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Brockmann
authors.affiliation: Department of Neurosurgery.
authors.forename: Alhadi
authors.initials: A
authors.lastname: Igressa
authors.affiliation: Department of Neurosurgery.
authors.forename: Patra
authors.initials: P
authors.lastname: Charalampaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D000069416:Intravital Microscopy / Q000379:methods; D008297:Male; D000072662:Margins of Excision; D018613:Microscopy, Confocal / Q000379:methods; D008875:Middle Aged; D057234:Preoperative Period; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D047368:Tumor Burden
keywords: basal cell carcinoma; confocal laser endomicroscopy; magnifying glass; squamous cell carcinoma