Gross total resection with fluorescence could lead to improved overall survival rates: a systematic review and meta-analysis

Nikova, Alexandrina; Vlotinou, Penelope; Karelis, Loukas; Karanikas, Michael; Birbilis, Theodossios

doi:10.1080/02688697.2021.1950637

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…IMRI was also associated with improved progression-free survival rates compared to FS and 5-ALA [33]. Intraoperative magnification with the combination of all three techniques was found to correspond to significantly higher rates of GTR in HGG [33]. While GTR has been significantly correlated to improved overall survival rates, further studies are needed to determine the association of these methods with the progression-free survival rate.…”

Section: Surgerymentioning

confidence: 90%

“…Recent efforts have been made towards techniques that can be used alongside maximal resections to improve progression-free and overall survival outcomes. Intraoperative MRI (IMRI) techniques with compounds like 5-aminolevulinic acid (5-ALA), and fluorescein sodium (FS) have been shown to increase the success of surgical resection [33]. In high-grade gliomas (HGG), malignant glial cell tumors in the brain and spinal cord, intraoperative imaging using 5-ALA and FS led to higher rates of GTR compared to control [33], with 5-ALA resulting in greater rates of overall survival compared to FS [34].…”

Section: Surgerymentioning

confidence: 99%

“…Intraoperative MRI (IMRI) techniques with compounds like 5-aminolevulinic acid (5-ALA), and fluorescein sodium (FS) have been shown to increase the success of surgical resection [33]. In high-grade gliomas (HGG), malignant glial cell tumors in the brain and spinal cord, intraoperative imaging using 5-ALA and FS led to higher rates of GTR compared to control [33], with 5-ALA resulting in greater rates of overall survival compared to FS [34]. IMRI was also associated with improved progression-free survival rates compared to FS and 5-ALA [33].…”

Section: Surgerymentioning

confidence: 99%

“…In high-grade gliomas (HGG), malignant glial cell tumors in the brain and spinal cord, intraoperative imaging using 5-ALA and FS led to higher rates of GTR compared to control [33], with 5-ALA resulting in greater rates of overall survival compared to FS [34]. IMRI was also associated with improved progression-free survival rates compared to FS and 5-ALA [33]. Intraoperative magnification with the combination of all three techniques was found to correspond to significantly higher rates of GTR in HGG [33].…”

Section: Surgerymentioning

confidence: 99%

“…Surgical resectioning is one of the more successful treatments in treating cerebral tumors and HBs, as studies have shown it to decrease disease progression [37,30]. The resectioning can also be assisted by intraoperative imaging like IMRI, 5-ALA, and FS has been shown to improve survival outcomes but requires more research [33]. A combination of surgical resectioning with radiotherapy demonstrates a two-fold increase in survival rates [57].…”

Section: Summary Of Existing and Novel Hb Treatmentsmentioning

confidence: 99%

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Emerging therapies of hemangioblastomas

Sanghadia,

Martinez,

McNulty

et al. 2023

Explor Neurosci

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Hemangioblastoma are benign, vascularized cranial tumors caused by autosomal dominant inherited von Hippel-Lindau disease or can appear sporadically. This review will investigate current and emerging treatments for cerebral tumors. It will focus on the current and, more importantly, developing hemangioblastoma treatments. Surgical resectioning and radiotherapy are effective treatment options for cerebral tumors, whereas chemotherapies are not commonly used due to their limited ability to penetrate the blood-brain barrier. Recent chemotherapies have shown promise, but further research is needed to determine the efficacy as a treatment for hemangioblastomas. New advances in brachytherapy and immunotherapy are considered promising treatment options for hemangioblastoma. This review aims to offer valuable insights into the latest developments in hemangioblastoma treatments.

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Section: Surgerymentioning

confidence: 90%

Section: Surgerymentioning

confidence: 99%

Section: Surgerymentioning

confidence: 99%

Section: Surgerymentioning

confidence: 99%

Section: Summary Of Existing and Novel Hb Treatmentsmentioning

confidence: 99%

See 3 more Smart Citations

Emerging therapies of hemangioblastomas

Sanghadia,

Martinez,

McNulty

et al. 2023

Explor Neurosci

View full text Add to dashboard Cite

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Surgical management of Glioma Grade 4: technical update from the neuro-oncology section of the Italian Society of Neurosurgery (SINch®): a systematic review

et al. 2023

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Purpose The extent of resection (EOR) is an independent prognostic factor for overall survival (OS) in adult patients with Glioma Grade 4 (GG4). The aim of the neuro-oncology section of the Italian Society of Neurosurgery (SINch®) was to provide a general overview of the current trends and technical tools to reach this goal. Methods A systematic review was performed. The results were divided and ordered, by an expert team of surgeons, to assess the Class of Evidence (CE) and Strength of Recommendation (SR) of perioperative drugs management, imaging, surgery, intraoperative imaging, estimation of EOR, surgery at tumor progression and surgery in elderly patients. Results A total of 352 studies were identified, including 299 retrospective studies and 53 reviews/meta-analysis. The use of Dexamethasone and the avoidance of prophylaxis with anti-seizure medications reached a CE I and SR A. A preoperative imaging standard protocol was defined with CE II and SR B and usefulness of an early postoperative MRI, with CE II and SR B. The EOR was defined the strongest independent risk factor for both OS and tumor recurrence with CE II and SR B. For intraoperative imaging only the use of 5-ALA reached a CE II and SR B. The estimation of EOR was established to be fundamental in planning postoperative adjuvant treatments with CE II and SR B and the stereotactic image-guided brain biopsy to be the procedure of choice when an extensive surgical resection is not feasible (CE II and SR B). Conclusions A growing number of evidences evidence support the role of maximal safe resection as primary OS predictor in GG4 patients. The ongoing development of intraoperative techniques for a precise real-time identification of peritumoral functional pathways enables surgeons to maximize EOR minimizing the post-operative morbidity.

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