 As one of the internationally leading teams in applying tissue fluorescence technology, we have shown that direct fluorescence visualization FV tools can identify clinically visible or occult premalignant and malignant lesions that are associated with lesions at risk, with high-grade histology and high-risk molecular change. In a recently small scaled, retrospective study, we have shown that FV helped surgeons in the operating room to determine the extent of the high-risk FV field surrounding the cancer and resulted in remarkably lower 2-year recurrence rates 0 for FV-guided vs. 25 for those without FV-guided approach. There is need to design a larger scale prospective, randomized controlled Phase III trial to gather strong evidence in proving the efficacy of the surgery approach using this adjunct tool. 