Hoehne, Julius and Schebesch, Karl-Michael and de Laurentis, Camilla and Akcakaya, Mehmet Osman and Pedersen, Christian Bonde and Brawanski, Alexander and Poulsen, Frantz Rom and Kiris, Talat and Cavallo, Claudio and Broggi, Morgan and Ferroli, Paolo and Acerbi, Francesco (2019) Fluorescein Sodium in the Surgical Treatment of Recurrent Glioblastoma Multiforme. WORLD NEUROSURGERY, 125. E158-E164. ISSN 1878-8750, 1878-8769
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: Glioblastoma multiforme (GBM) is the most common primary brain tumor and has a high recurrence rate. Maximizing the extent of resection (EOR) in recurrent GBM has proved to be the cornerstone of neurosurgical retreatment. The development of surgical microscopes fitted with fluorescein-specific filters has facilitated fluorescein-guided microsurgery and the identification of tumor tissue. Use of fluorescein sodium (FL) in primary high-grade glioma resection has shown promising results. Here, we present our experience with FL and the dedicated surgical microscope filter YELLOW 560 nm in 106 patients with recurrent GBM. METHODS: A total of 106 patients with recurrent GBM were included (53 women, 53 men; mean age, 53 years). A total of 5 mg/kg bodyweight of FL was intravenously injected approximately 45 minutes before craniotomy. A YELLOW 560 nm filter (PENTERO 900 [Carl Zeiss Meditec, Oberkochen Germany]) was used for microsurgical tumor resection and resection control. Surgical reports were reviewed regarding the degree of fluorescent staining. Postoperative magnetic resonance images were examined within 48 hours after surgery regarding the EOR and postoperative course regarding neurologic outcome, complications, and any adverse events. RESULTS: Bright fluorescent staining was present in all patients, which markedly enhanced tumor visibility and was deemed helpful for tumor resection. Seventeen patients (16%) showed residual tumor tissue on postoperative magnetic resonance imaging (MRI). Therefore, gross total resection was achieved in 89 patients (84%). No adverse events were registered postoperatively. CONCLUSIONS: FL and YELLOW 560 nm are readily available methods for fluorescence-guided tumor resection, similar to contrast enhancement in T1-weighted MRI. FL may improve resection in recurrent GBM with minimal risk, and tumor margins are clearly visualized. FL and the YELLOW 560 nm filter are safe and feasible tools for safe maximal resection of recurrent glioblastoma.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HIGH-GRADE GLIOMAS; GUIDED SURGERY; INTRAOPERATIVE FLUORESCENCE; MICROSCOPE FILTER; TUMOR VOLUME; RESECTION; SURVIVAL; EXTENT; BRAIN; ASSOCIATION; Fluorescein sodium; Fluorescence-guided surgery; High-grade glioma; Neurosurgery; PENTERO 900; Recurrent glioblastoma; Surgical microscope; YELLOW 560 nm filter |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Apr 2020 06:42 |
| Last Modified: | 09 Apr 2020 06:42 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27079 |
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