CACA guidelines for fluorescence-guided surgery with indocyanine green (oral cancer section)

Abstract Oral squamous cell carcinoma (OSCC) presents a substantial global health threat with high incidence and mortality rates. Locoregional recurrence remains a major challenge. Recent advancements in near-infrared (NIR) fluorescence-guided surgery (FGS), particularly using Indocyanine Green (ICG), shows promise in enhancing both diagnostic precision and surgery guidance. ICG exploits the enhanced permeability and retention (EPR) effect, allowing it to accumulate in tumor tissue and guide surgical resection. However, the application of fluorescence imaging with ICG in the surgical treatment of OSCC is still in its early stages, lacking standardized protocols in indications, procedural guidelines, and delivery precautions. Herein, we summarized collaborative consensus among experts from multiple medical institutions and references from both domestic and international literature, as well as multicenter clinical studies on ICG-guided surgery for OSCC, aiming to provide guidance for clinical practices in OSCC surgical treatment with ICG. This consensus advocates for the widespread adoption of ICG-guided surgery to improve surgical navigation, tumor margin delineation and efficiency of pathological assessment in OSCC treatment.