Delicate touch.

Have you ever wondered why more surgical oncologists don’t embrace the concept of real-time radial margin assessments à la Mohs surgeons? Sure, oncologic resections of the esophagus and stomach are a different ball game than that of the skin where patients can watch HGTV with disfiguring wounds during margin assessments. But it’s not so different when you consider you’d like to lose the least possible amount of healthy esophagus or stomach just as you would your nose or ear. Enter multispectral optical probes which can intra-operatively analyze “otherwise invisible tissue and cellular changes at microscale and nanoscale levels, present at both early and late stages of malignant transformation.” In this promising prospective study of 34 patients undergoing esophageal or gastric cancer resection in the UK, a handheld diffuse reflectance spectroscopy probe used on fresh resected en bloc tissue specimens was able to distinguish malignant from healthy tissue with 91-95% sensitivity and 95-97% specificity when compared to final histopathology. | Nazarian, JAMA Surg 2022