5-Aminolevulinic Acid Fluorescence in High Grade Glioma Surgery: Surgical Outcome, Intraoperative Findings, and Fluorescence Patterns. (7th April 2014)

• Record Type: Journal Article
• Authors: Puppa, Alessandro Della; Ciccarino, Pietro; Lombardi, Giuseppe; Rolma, Giuseppe; Cecchin, Diego; Rossetto, Marta
• Other Names: Stefano Anna Luisa Di Academic Editor.
• Is Part Of: BioMed research international. Volume 2014(2014)
• Publication Date: 2014-04-07
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2014/232561
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : Background . 5-Aminolevulinic acid (5-ALA) fluorescence is a validated technique for resection of high grade gliomas (HGG); the aim of this study was to evaluate the surgical outcome and the intraoperative findings in a consecutive series of patients. Methods . Clinical and surgical data from patients affected by HGG who underwent surgery guided by 5-ALA fluorescence at our Department between June 2011 and February 2014 were retrospectively evaluated. Surgical outcome was evaluated by assessing the resection rate as gross total resection ( GTR ) > 98 % and GTR > 90 %. We finally stratified data for recurrent surgery, tumor location, tumor size, and tumor grade (IV versus III grade sec. WHO). Results . 94 patients were finally enrolled. Overall GTR > 98 % and GTR > 90 % was achieved in 93% and 100% of patients. Extent of resection ( GTR > 98 % ) was dependent on tumor location, tumor grade ( P < 0.05 ), and tumor size ( P < 0.05 ) . In 43% of patients the boundaries of fluorescent tissue exceeded those of tumoral tissue detected by neuronavigation, more frequently in larger (57%) ( P < 0.01 ) and recurrent (60%) tumors. Conclusions . 5-ALA fluorescence in HGG surgery enables a GTR in 100% of cases even if selection of patients remains a main bias. Recurrent surgery, and location, size, and tumor grade can predict both the surgical outcome and the intraoperative findings.