Systematic classification of confocal laser endomicroscopy for the diagnosis of oral cavity carcinoma

•Confocal laser endomicroscopy enables real-time, non-invasive identification of malignancy in oral cavity.•Confocal laser endomicroscopy classification scores for the pharynx and larynx are also valid in the oral mucosa.•Sensitivity and specificity for carcinoma were 90.1 % and 87.4 %, respectively.•Confocal laser endomicroscopy can be performed with a substantial interrater agreement (k = 0.775) and high accuracy (AUC = 0.935).•Presently, confocal laser endomicroscopy can aid intraoperative assessment but does not replace histology.