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Sodium Fluorescein-Guided Resection of Brain Metastases: A Needed Approach or an Option? a Systematic Review and Meta-Analysis Publisher Pubmed



Ohadi MAD1, 2 ; Dashtkoohi M1 ; Babaei MR1 ; Zamani R1 ; Dashtkoohi M1 ; Hadjipanayis CG3
Authors
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Authors Affiliations
  1. 1. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Pediatric Neurological Surgery, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, United States

Source: Acta Neurochirurgica Published:2024


Abstract

Purpose: 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. Methods: 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. Results: 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%). Conclusion: 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. © The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2024.