التفاصيل البيبلوغرافية
| العنوان: |
Does 5-ALA Fluorescence Microscopy Improve Complete Resectability in Cerebral/Cerebellar Metastatic Surgery? A Retrospective Data Analysis from a Cranial Center. |
| المؤلفون: |
Sarkis, Hraq Mourad1,2,3 (AUTHOR) cewelt@barbaraklinik.de, Zawy Alsofy, Samer1,2 (AUTHOR) ralf@stroop.de, Stroop, Ralf1 (AUTHOR) mlewitz@barbaraklinik.de, Lewitz, Marc1,2 (AUTHOR) munnewehr@barbaraklinik.de, Schipmann, Stephanie4 (AUTHOR) stephanie.schipmann@googlemail.com, Unnewehr, Markus1 (AUTHOR), Paulus, Werner5 (AUTHOR) werner.paulus@uni-muenster.de, Nakamura, Makoto6 (AUTHOR) nakamuram@kliniken-koeln.de, Ewelt, Christian2 (AUTHOR) |
| المصدر: |
Cancers. Jun2024, Vol. 16 Issue 12, p2242. 18p. |
| مصطلحات موضوعية: |
*FLUORESCENT dyes, *ADENOCARCINOMA, *POSTOPERATIVE care, *GASTROINTESTINAL tumors, *SQUAMOUS cell carcinoma, *MICROSURGERY, *ACADEMIC medical centers, *T-test (Statistics), *MELANOMA, *SURVIVAL rate, *BREAST tumors, *KARNOFSKY Performance Status, *GIANT cell tumors, *SURGICAL therapeutics, *MAGNETIC resonance imaging, *CANCER patients, *CHI-squared test, *RETROSPECTIVE studies, *METASTASECTOMY, *METASTASIS, *IMMUNOHISTOCHEMISTRY, *KAPLAN-Meier estimator, *LOG-rank test, *POSTOPERATIVE period, *DATA analysis software, *SMALL cell carcinoma, *PROGRESSION-free survival, *CONFIDENCE intervals, *BRAIN tumors, *PATIENT aftercare, *BRONCHIAL tumors, *OVERALL survival |
| مصطلحات جغرافية: |
GERMANY |
| مستخلص: |
Simple Summary: In the present study, the intraoperative fluorescence of brain metastases after the administration of 5-aminolevulinic acid (5-ALA) is investigated in 80 cases. Brain metastases fluoresced in 57.5% of cases, with no significant correlation between fluorescence and primary tumor or histological subtype. Complete resection of brain metastases was detected in 82.5%, of which 56.1% were fluorescence positive, compared to 43.9% which were non-fluorescent. Thus, prior administration of 5-ALA tended to improve the resectability rate by 12.1%. Fluorescence-positive and -negative metastases showed significantly different overall survival in this study. Therefore, administration of 5-ALA as a surgical adjuvant may be beneficial in resecting brain metastases and may potentially optimize the surgical procedure. (1) Background: In this study, the intraoperative fluorescence behavior of brain metastases after the administration of 5-aminolevulinic acid (5-ALA) was analyzed. The aim was to investigate whether the resection of brain metastases using 5-ALA fluorescence also leads to a more complete resections and thus to a prolongation of survival; (2) Methods: The following variables have been considered: age, sex, number of metastases, localization, involvement of eloquent area, correlation between fluorescence and primary tumor/subtype, resection, and survival time. The influence on the degree of resection was determined with a control MRI within the first three postoperative days; (3) Results: Brain metastases fluoresced in 57.5% of cases. The highest fluorescence rates of 73.3% were found in breast carcinoma metastases and the histologic subtype adenocarcinoma (68.1%). No correlation between fluorescence behavior and localization, primary tumor, or histological subtype was found. Complete resection was detected in 82.5%, of which 56.1% were fluorescence positive. There was a trend towards improved resectability (increase of 12.1%) and a significantly longer survival time (p = 0.009) in the fluorescence-positive group; (4) Conclusions: 5-ALA-assisted extirpation leads to a more complete resection and longer survival and can therefore represent a low-risk addition to modern surgery for brain metastases. [ABSTRACT FROM AUTHOR] |
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