Outcome comparisons of high-grade glioma resection with or without fluorescein sodium-guidance

Curr Probl Cancer. 2019 Jun;43(3):236-244. doi: 10.1016/j.currproblcancer.2018.07.007. Epub 2018 Aug 7.

Abstract

Purpose: To compare surgical outcomes and adverse events between patients received microsurgical resection of high-grade gliomas with or without fluorescein sodium-guidance.

Patients: A retrospective study was conducted in our hospital between June 2016 and January 2017. Patients were divided into 2 groups: Fluorescein Group (42 patients) and Nonfluorescein Group (40 patients).

Measurements: Intraoperative (hemorrhage value and operation time) and postoperative (consistency between fluorescence-stained tissue and histopathological results, rate of resection) measurements were documented. Postoperative adverse events were recorded. Patients were followed up for 6 months to evaluate postsurgery glioma recurrence.

Main results: Intraoperatively, hemorrhage value, and operation time were significantly less in Fluorescencein than in Nonfluorescencein group. The rate of glioma complete resection was significantly higher in Fluorescencein than in Nonfluorescencein group (85.7%vs 62.5%, P = 0.02). The rate of glioma recurrence was significantly lower in Fluorescencein than in Nonfluorescencein group (11.9%vs 25.0%, P = 0.01), and no significant differences on adverse events were observed.

Conclusions: Intraoperative fluorescein sodium-guidance could facilitate the complete resection and significantly decrease the postoperative recurrence in patients with high-grade gliomas.

Keywords: Fluorescein sodium; high-grade glioma; postsurgery recurrence; surgical resection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / pathology
  • Brain Neoplasms / surgery*
  • Case-Control Studies
  • Female
  • Fluorescein / metabolism*
  • Follow-Up Studies
  • Glioma / metabolism
  • Glioma / pathology
  • Glioma / surgery*
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control*
  • Neurosurgical Procedures / methods*
  • Postoperative Complications*
  • Prognosis
  • Retrospective Studies
  • Surgery, Computer-Assisted / methods*

Substances

  • Fluorescein