Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients
It is commonly reported that maximizing surgical resection of contrast-enhancing regions in patients with glioblastoma improves overall survival. Efforts to achieve an improved rate of resection have included several tools: among those, the recent widespread of fluorophores. Sodium fluorescein is an...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/1/178 |
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| author | Jacopo Falco Emanuele Rubiu Morgan Broggi Mariangela Farinotti Ignazio G. Vetrano Marco Schiariti Elena Anghileri Marica Eoli Bianca Pollo Marco Moscatelli Francesco Restelli Elio Mazzapicchi Emanuele La Corte Giulio Bonomo Marco Gemma Giovanni Broggi Paolo Ferroli Francesco Acerbi |
| author_facet | Jacopo Falco Emanuele Rubiu Morgan Broggi Mariangela Farinotti Ignazio G. Vetrano Marco Schiariti Elena Anghileri Marica Eoli Bianca Pollo Marco Moscatelli Francesco Restelli Elio Mazzapicchi Emanuele La Corte Giulio Bonomo Marco Gemma Giovanni Broggi Paolo Ferroli Francesco Acerbi |
| author_sort | Jacopo Falco |
| collection | DOAJ |
| description | It is commonly reported that maximizing surgical resection of contrast-enhancing regions in patients with glioblastoma improves overall survival. Efforts to achieve an improved rate of resection have included several tools: among those, the recent widespread of fluorophores. Sodium fluorescein is an unspecific, vascular dye which tends to accumulate in areas with an altered blood–brain barrier. In this retrospective analysis of patients prospectively enrolled in the FLUOCERTUM study, we aimed to assess the role of fluorescein-guided surgery on surgical radicality, survival, and morbidity. A retrospective review based on 93 consecutively and prospectively enrolled IDH wild-type glioblastoma patients (2016–2022) was performed; fluorescence characteristics, rate of resection, clinical outcome, and survival were analyzed. No side effect related to fluorescein occurred; all of the tumors presented a strong yellow-green enhancement and fluorescein was judged fundamental in distinguishing tumors from viable tissue in all cases. Gross total resection was achieved in 77 cases out of 93 patients (82.8%). After a mean follow-up time of 17.4 months (3–78 months), the median progression-free survival was 12 months, with a PFS-6 and PFS-12 of 94.2% and 50%, respectively, whereas median overall survival was estimated to be 16 months; survival at 6, 12, and 24 months was 91.8%, 72.3%, and 30.1%, respectively. Based on these results, we can assert that the fluorescein-guided technique is a safe and valuable method for patients harboring a newly diagnosed, untreated glioblastoma. |
| first_indexed | 2024-03-11T09:56:59Z |
| format | Article |
| id | doaj.art-84be2aa129b24723a1f08214431a5c6b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:56:59Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-84be2aa129b24723a1f08214431a5c6b2023-11-16T15:42:31ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112117810.3390/jcm12010178Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma PatientsJacopo Falco0Emanuele Rubiu1Morgan Broggi2Mariangela Farinotti3Ignazio G. Vetrano4Marco Schiariti5Elena Anghileri6Marica Eoli7Bianca Pollo8Marco Moscatelli9Francesco Restelli10Elio Mazzapicchi11Emanuele La Corte12Giulio Bonomo13Marco Gemma14Giovanni Broggi15Paolo Ferroli16Francesco Acerbi17Neurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeuroepidemiology Unit, Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyUnit of Molecular Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyUnit of Molecular Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Biomedical Sciences for Health, University of Milan, 20122 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurointensive Care Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurosurgical Unit 2, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyIt is commonly reported that maximizing surgical resection of contrast-enhancing regions in patients with glioblastoma improves overall survival. Efforts to achieve an improved rate of resection have included several tools: among those, the recent widespread of fluorophores. Sodium fluorescein is an unspecific, vascular dye which tends to accumulate in areas with an altered blood–brain barrier. In this retrospective analysis of patients prospectively enrolled in the FLUOCERTUM study, we aimed to assess the role of fluorescein-guided surgery on surgical radicality, survival, and morbidity. A retrospective review based on 93 consecutively and prospectively enrolled IDH wild-type glioblastoma patients (2016–2022) was performed; fluorescence characteristics, rate of resection, clinical outcome, and survival were analyzed. No side effect related to fluorescein occurred; all of the tumors presented a strong yellow-green enhancement and fluorescein was judged fundamental in distinguishing tumors from viable tissue in all cases. Gross total resection was achieved in 77 cases out of 93 patients (82.8%). After a mean follow-up time of 17.4 months (3–78 months), the median progression-free survival was 12 months, with a PFS-6 and PFS-12 of 94.2% and 50%, respectively, whereas median overall survival was estimated to be 16 months; survival at 6, 12, and 24 months was 91.8%, 72.3%, and 30.1%, respectively. Based on these results, we can assert that the fluorescein-guided technique is a safe and valuable method for patients harboring a newly diagnosed, untreated glioblastoma.https://www.mdpi.com/2077-0383/12/1/178glioblastomasodium fluoresceinneuro-oncologyYELLOW 560 filterfluorescence-guided neurosurgerygross total resection |
| spellingShingle | Jacopo Falco Emanuele Rubiu Morgan Broggi Mariangela Farinotti Ignazio G. Vetrano Marco Schiariti Elena Anghileri Marica Eoli Bianca Pollo Marco Moscatelli Francesco Restelli Elio Mazzapicchi Emanuele La Corte Giulio Bonomo Marco Gemma Giovanni Broggi Paolo Ferroli Francesco Acerbi Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients Journal of Clinical Medicine glioblastoma sodium fluorescein neuro-oncology YELLOW 560 filter fluorescence-guided neurosurgery gross total resection |
| title | Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients |
| title_full | Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients |
| title_fullStr | Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients |
| title_full_unstemmed | Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients |
| title_short | Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients |
| title_sort | towards an established intraoperative oncological favorable tool results of fluorescein guided resection from a monocentric prospective series of 93 primary glioblastoma patients |
| topic | glioblastoma sodium fluorescein neuro-oncology YELLOW 560 filter fluorescence-guided neurosurgery gross total resection |
| url | https://www.mdpi.com/2077-0383/12/1/178 |
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