Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Pediatric Neurological Surgery, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Acta Neurochir (Wien). 2024 Aug 12;166(1):334. doi: 10.1007/s00701-024-06223-7.
Brain metastases (BM) often leave residual tumors despite having visible margins, which increases the risk of local tumor recurrence and can impact overall patient survival rates. Fluorescence-guided surgery (FGS) utilizing sodium fluorescein (FL) has been reported as an effective technique in recent studies. This study aimed to evaluate the efficacy of FL FGS in improving the extent of resection of brain metastases and its impact on overall survival.
We conducted a systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Our primary focus was on gross total resection (GTR). Additionally, we extracted survival data and evaluated the risk of bias using a modified version of the Joanna Briggs Institute critical appraisal tool.
The study comprised 970 patients with brain metastases through eight different studies. The study found that patients who underwent FL-guided resection had a significantly higher rate of GTR (OR: 2.02, 95% CI: 1.14-3.56, p = 0.0156, I2 = 41.5%). Additionally, the study concluded that FL-guided resection is associated with better overall survival rates (HR: 0.61, 95%CI: 0.47 0.80, p = 0.0003, I2 = 41.5%).
Our research suggests that the use of FL is associated with a higher rate of GTR and improved overall patient survival. None of the studies we reviewed reported significant complications associated with the use of FL in patients.
尽管脑转移瘤（BM）的边缘可见，但仍常留有残余肿瘤，这增加了局部肿瘤复发的风险，并可能影响患者的总生存率。最近的研究报告称，利用荧光素钠（FL）的荧光引导手术（FGS）是一种有效的技术。本研究旨在评估 FL FGS 提高脑转移瘤切除程度的效果及其对总生存率的影响。
我们按照系统评价和荟萃分析的首选报告项目进行了系统搜索。我们的主要重点是全切除（GTR）。此外，我们提取了生存数据，并使用乔安娜·布里格斯研究所（Joanna Briggs Institute）批判性评估工具的修改版本评估了偏倚风险。
该研究纳入了 8 项不同研究的 970 例脑转移瘤患者。研究发现，接受 FL 引导切除的患者 GTR 率显著更高（OR：2.02，95%CI：1.14-3.56，p=0.0156，I2=41.5%）。此外，研究还得出结论，FL 引导切除与更好的总生存率相关（HR：0.61，95%CI：0.47-0.80，p=0.0003，I2=41.5%）。
我们的研究表明，FL 的使用与更高的 GTR 率和改善的总体患者生存率相关。我们回顾的研究均未报告与患者使用 FL 相关的重大并发症。
