Background: 5-aminolevulinic acid (5-ALA) enhances intraoperative high grade glioma (HGG) tissue visualization. Despite promising randomized clinical trial data suggesting survival benefit for 5-ALA-guided HGG surgery, patient outcome efficacy is not universally accepted. Methods: We performed a systematic review of the literature to evaluate whether there is a beneficial effect upon survival and extent of resection from the utilization of 5-ALA in HGG surgery. Literature regarding 5-ALA usage in HGG surgery was reviewed according to PRISMA guidelines. Results: 3,756 published studies were screened, 536 evaluated, and 45 included. Of studies that directly compared the use of 5-ALA to white light (28.9%), 5-ALA lead to a better progression-free survival (PFS) and overall survival (OS) in 88.4 and 67.5% of patients, respectively. 42.2% demonstrated that 5-ALA use was associated with less post-op neurological deficits, whereas 23.3% of studies showed that surgeries using 5-ALA lead to more deficits. 34.5% demonstrated no difference between 5-ALA and without. Conclusions: 5-ALA was found to be associated with a greater extent of resection and longer OS and PFS in HGG surgeries. Postop neurologic deficit rates were inconclusive when comparing 5-ALA groups to white light groups. 5-ALA is a useful surgical adjunct for HGG resection with preserved patient safety.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.