Senada Koljenović

Presenation
Patients with oral cavity cancer are often treated with surgery. Of the many factors that may affect the clinical outcome of patients with OCSCC (such as tumor site, TNM classification, patient age, comorbidity) only the resection margin is under the control of the surgeon and the pathologist. The goal is to remove the tumor with a margin of > 5 mm of surrounding healthy tissue, according to the international guideline of Royal College of Pathologists. This results in the best patient outcome through highest 5-year survival, less need for adjuvant radiotherapy/chemotherapy, better quality of life, less tumour recurrence. This is referred to as “adequate surgery”. However, in the oral cavity region many important and delicate functional tissue structures should be spared if possible. Moreover, it is often impossible for the surgeon to accurately delineate the tumour in the operating room by visual inspection and palpation alone. Unfortunately, as a result only about 15% to 26% of the oral cancer surgeries achieve adequate resection margins. Intraoperative assessment of tumor resection margins can dramatically improve surgical results. It enables the surgico-pathological team to directly perform additional tissue resection, if necessary, to achieve a so-called “first time right surgery”. However, current methods are laborious, subjective, and logistically demanding. This hinders broad adoption of intraoperative assessment of tumor resection margins, to the detriment of patients. Inadequate resection margins result in the need for a 2nd, sometimes 3rd operation, combined or not with chemotherapy or radiotherapy. Therefore, an objective easy-to-use technique is needed, to accurately assess all resection margins intraoperatively. The challenges in pathology and the opportunities of photonic techniques in general will be discussed. The development of a Raman spectroscopic technology, for quick and objective intraoperative measurement of resection margins will be presented.

Bio
Professor and Head of the Pathology department, and Consultant Pathologist at Antwerp University Hospital / University of Antwerp (Belgium), where she mainly focuses on Head and Neck pathology and Dermatopathology.
Within Head and Neck pathology, she works intensively on improving surgical-pathological communication and correlation of information for better diagnosis, surgical results and patient outcome.

She is a clinical pathologist-PI within a multidisciplinary research group including the Departments of Pathology, ENT and Head and Neck surgery, Maxillofacial and Head and Neck surgery, Dermatology. She furthermore coordinates close collaboration with other academic Head and Neck centers and affiliated non-academic institutes, to facilitate design and execution of large multi-center studies.

Her Ph.D – thesis focused on clinical application of Raman spectroscopy. Her department of Pathology has an open door policy for developments in photonics and optical spectroscopies and is a bridge between clinical practice and Photonics, to enable improved diagnosis and treatment of different diseases.
Research is translational with focus on medical applications of Photonics in general, and in particular applications of Raman spectroscopy-based tools in Head and Neck surgery (Raman-guided surgical resections facilitating safe surgical margins in oral cancer) and in characterisation of pre-neoplasia for its’s early diagnosis.