Effect of Sodium Fluorescein Use on Surgical Outcomes and Survival in Cases with High Graded Glial Tumor : A retrospective study

Yıl 2022, Cilt: 8 Sayı: 4, 592 - 602, 30.11.2022

Tamer Tunçkale Tezcan Çalışkan

https://doi.org/10.19127/mbsjohs.1143930

Öz

Objective: The most effective factor on malignant glioma (MGs) treatment affecting overall survival is the extent of resection. The use of sodium fluorescein (FL) staining in order to increase the amount of resection, is applied more effectively and safely at lower doses with the aid of 560nm filtered surgical microscopes. Our aim was to investigate the effects of the use of FL in MGs surgery on the gross total resection rate (GTR), duration of surgery, length of hospital stays, and survival time.
Methods: A retrospective study was conducted on 17 patients whose histopathological evaluations were reported as MGs and operated under surgical white light (Group 1), and 23 patients who were operated under FL560 module surgical microscope (Group 2) with a low dose of (3mg/kg body weight) FL dye. The blood loss in the course of surgery, GTR, surgical time, and hospital stay were compared for both groups with the student-t-test. Kaplan-Meier method was used for the survival time analysis.
Results: GTR rates were found to be 82.3% for patients operated under surgical white light, and the percentage for FL-utilized patients was 91.3%. There was no significant difference in blood loss or hospital stay between the two groups; however, the surgical time for FL-utilized patients was found to be significantly low in comparison to the other group. The overall survival time for patients who were operated under surgical white light was found to be 64 weeks (448 ± 64 days) while it was determined as 84.7 weeks (593±55 days) for patients operated with the use of FL, however, the difference between them was not found out to be statistically significant. The use of FL enabled the surgeon to determine the cortical incision area in 13 cases, where the location of the tumor was close to the cortex.
Conclusions: While the use of FL shortens the surgical time in contrast-enhancing MGs, it increases the GTR rate. FL also functions well with the determination of the location of the surgical site for tumors close to the cortex.

Anahtar Kelimeler

sodium fluorescein, high grade glioma, surgical resection

Proje Numarası

yok

Kaynakça

• 1- Quinn T Ostrom, Haley Gittleman, Paul Farah, Annie Ondracek, Yanwen Chen, Yingli Wolinsky, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006–2010. Neuro-oncol. 2013;15(sup 6): p1–56.
• 2- Sant M, Minicozzi P, Lagorio S, Johannesen T B, Marcos-Gragera R, Francisci S, EUROCARE Working Group. Survival of European patients with central nervous system tumors. Int J Cancer. 2012;131(1):173 – 185.
• 3- James R. Perry, Normand Laperriere, Christopher J. O'Callaghan, Alba Ariela Brandes, Johan Menten, Claire Phillips, et al. A phase III randomized controlled trial of short-course radiotherapy with or without concomitant and adjuvant temozolomide in elderly patients with glioblastoma (CCTG CE.6, EORTC 26062-22061, TROG 08.02, NCT00482677). J Clin Oncol. 2016;34(18): Abstract. doi:10.1200/JCO.2016. 34.18_suppl.LBA2.
• 4- Almeida JP, Chaichana KL, Rincon-Torroella J, Quinones-Hinojosa A. The value of extent of resection of glioblastomas: clinical evidence and current approach. Curr Neurol Neurosci Rep. 2015;15(2):517. doi:10.1007/ s11910-014-0517-x.
• 5- Nancy Ann Oberheim Bush, Susan M Chang , Mitchel S Berger . Current and future strategies for treatment of glioma. Neurosurg Rev 2017;40:1–14 DOI 10.1007/s10143-016-0709-8.
• 6- Michael Weller, Martin van den Bent, Jörg C Tonn . European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas. Lancet Oncol 2017;18(6):e315-e329. doi: 10.1016/S1470-2045(17)30194-8.
• 7- Moore GE, Peyton WT, French LA, Walker WW. The clinical use of fluorescein in neurosurgery; the localization of brain tumors. J Neurosurg 1948;5(4):392–8.doi:10.3171/jns.1948.5.4.0392.
• 8- Chen B, Wang H, Ge P, Zhao J, Li W, Gu H, Wang G, Luo Y, Chen D:. Gross total resection of glioma with the intraoperative fluorescence-guidance of fluorescein sodium. Int J Med Sci. 2012;9(8):708-714.
• 9- Dilek O, Ihsan A, Tulay H. Anaphylactic reaction after fluorescein sodium administration during intracranial surgery, J. Clin. Neurosci. 2011;18:430–431.
• 10- Francesco Acerbi, Morgan Broggi, Marica Eoli, Elena Anghileri, Lucia Cuppini, Bianca Pollo, et al. Fluorescein- guided surgery for grade IV gliomas with a dedicated filter on the surgical microscope: preliminary results in 12 cases. Acta Neurochir. 2013;155(7):1277–86.doi:10.1007/s00701-013-1734-9.
• 11- Kuroiwa T, Kajimoto Y, Ohta T. Development of a fluorescein operative microscope for use during malignant glioma surgery: A technical note and preliminary report. Surg Neurol. 1998;50(1):41- 48; discussion 48-49.
• 12- Acerbi F, Broggi M, Eoli M, Anghileri E, Cavallo C, Boffano C, et al. Is fluorescein-guided technique able to help in resection of high-grade gliomas? Neurosurg. Focus 36 (2014) E5.
• 13- Schebesch KM, Proescholdt M, Höhne J, Hohenberger C, Hansen E, Riemenschneider MJ, et al. Sodium fluorescein-guided resection under the YELLOW 560 nm surgical microscope filter in malignant brain tumor surgery- a feasibility study, Acta Neurochir. (Wien) 2013;155:693–699.
• 14- Hamamcıoğlu MK, Akçakay MO, Göker B, Kasımcan MÖ, Kırış T. The use of the YELLOW 560 nm surgical microscope filter for sodium fluorescein-guided resection of brain tumors: Our preliminary results in a series of 28 patients. Clinical Neurology and Neurosurgery. 2016;143:39–45. doi: 10.1016/j.clineuro.2016.02.006.
• 15- Wesseling P, Capper D. WHO 2016 Classification of gliomas. Neuropathol Appl Neurobiol, 2018;44(2):139-150. doi: 10.1111/nan.12432.
• 16- Stupp R, Mason Van Den Bent WP, Weller MJM, Fisher B, Taphoorn MJB, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N. Engl. J. Med. 2005;352:987–996.
• 17- Rey-Dios R, Hattab EM, Cohen-Gadol AA. Use of intraoperative fluorescein sodium fluorescence to improve the accuracy of tissue diagnosis during stereotactic needle biopsy of high- grade gliomas. Acta Neurochir. 2014;156(6):1071-1075.
• 18- Cavallo C, De Laurentis C, Vetrano IG, Falco J, Broggi M, Schiariti M, et al. The utilization of fluorescein in brain tumor surgery: a systematic review. J Neurosurg Sci. 2018;62:690–703. doi: 10.23736/S0390-5616.18.04480-6.
• 19- Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen HJ. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol. 2006;7:392–401.doi: 10.1016/s1470-2045(06)70665-9.
• 20- Acerbi F, Vetrano IG, Sattin T, de Laurentis C, Bosio L, Rossini Z, et al. The role of indocyanine green videoangiography with FLOW 800 analysis for the surgical management of central nervous system tumors: an update. Neurosurg Focus. 2018;44:E6. doi: 10.3171/2018.3.FOCUS1862.
• 21- Kuroiwa T, Kajimoto Y, Ohta T. Surgical management for supratentorial astrocytic tumors. Minim Invasive Neurosurg. 42(4):182-186, 1999.
• 22- Schebesch KM, Hoehne J, Hohenberger C, Acerbi F, Broggi M, Proescholdt M, et al. Fluorescein sodium-guided surgery in cerebral lymphoma. Clin Neurol Neurosurg. 2015;139:125–8. doi: 10.1016/j.clineuro.2015.09.015.
• 23- Höhne J, Hohenberger C, Proescholdt M, Riemenschneider MJ, Wendl C, Brawanski A, et al. Fluorescein sodium-guided resection of cerebral metastases—an update. Acta Neurochir. 2017;159:363–7.
• 24- Höhne J, Schebesch KM, de Laurentis C, Akçakaya MO, Pedersen CB, Brawanski A, et al. Fluorescein Sodium in the Surgical Treatment of Recurrent Glioblastoma Multiforme. World Neurosurg. 2019;125:e158-e164. doi: 10.1016/j.wneu.2019.01.024.
• 25- Göker B, Kırış T. Sodium fluorescein–guided brain tumor surgery under the YELLOW-560-nm surgical microscope filter in pediatric age group: feasibility and preliminary results. Childs Nerv Syst. 2019;35(3):429-435. doi: 10.1007/s00381-018-04037-4.
• 26- Duffau H. Lessons from brain mapping in surgery for low-grade glioma: insights into associations between tumour and brain plasticity. The Lancet Neurology. 2005;4(8):476– 486.
• 27- Koc K, Anik I, Cabuk B, Ceylan S. Fluorescein sodium-guided surgery in glioblastoma multiforme: A prospective evaluation. Br J Neurosurg. 2008;22(1):99-103.
• 28- Gennadiy A Katsevman, Ryan C Turner, Ogaga Urhie, Joseph L Voelker, Sanjay Bhatia. Utility of sodium fluorescein for achieving resection targets in glioblastoma: increased gross- or near-total resections and prolonged survival. J Neurosurg. 2019;132(3):914-920. doi: 10.3171/2018.10.JNS181174.