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66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Friendship Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

7. - 10. Juni 2015, Karlsruhe

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Preliminary results of a multicentre phase-II study (FLUOGLIO) on fluorescein-guided surgery for resection of malignant gliomas

Meeting Abstract

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  • Acerbi Francesco - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Broggi Morgan - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Schebesch Karl-Michael - Department of Neurosurgery, University Hospital Regensburg, Germany
  • Hoehne Julius - Department of Neurosurgery, University Hospital Regensburg, Germany
  • Eoli Marica - Molecular Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Anghileri Elena - Molecular Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Schiariti Marco - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Cordella Roberto - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Cuppini Lucia - Molecular Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Cavallo Claudio - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Boffano Carlo - Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Pollo Bianca - Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Orsi Chiara - Biostatistic and Clinic Epidemiology, Department of Public Health, Forensic and Experimental Medicine, University of Pavia
  • Brawanski Alexander - Department of Neurosurgery, University Hospital Regensburg, Germany
  • Broggi Giovanni - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
  • Ferroli Paolo - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocDI.14.05

doi: 10.3205/15dgnc172, urn:nbn:de:0183-15dgnc1726

Veröffentlicht: 2. Juni 2015

© 2015 Francesco et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Sodium fluorescein capability to accumulate in cerebral areas with blood-brain barrier damage makes it an ideal dye for intraoperative visualization of high-grade gliomas (HGG). A fluorescein-guided technique for HGG removal with a dedicated filter on the surgical microscope is presented (FLUOGLIO trial).

Method: The FLUOGLIO study is a prospective multicentre phase II-trial to evaluate safety and obtain indications about efficacy of fluorescein-guided surgery for HGG. Until November 2014, 36 patients (mean age 62.6, range 40-75) were enrolled. Fluorescein was intravenously injected after intubation or immediately before the procedure in awake patients (5-10 mg/Kg). Tumor was removed with microsurgical technique and fluorescence visualization by BLU400 or YELLOW560 filters on the Pentero microscope (Carl Zeiss, Germany). Degree of tumor resection was calculated on an early (within 72 hours of surgery) postoperative MRI.

In 12 patients, biopsies were performed at the tumor margin to evaluate sensitivity and specificity of fluorescein in tumor tissue identification.

Results: Median pre-operative tumor volume was 29.7 cm3 (1.3-87.8 cm3). No adverse reaction related to the administration of fluorescein was registered. Contrast-enhanced tumor was completely removed in 86% of the patients on early postoperative MRI (31/36). The remaining patients had a mean tumor resection of 92%. With a median follow-up of 14 months, the 6 months PFS rate was 78% and median survival was 14 months. Estimation of sensitivity and specificity of fluorescein in identifying tumor tissue was 83% and 82% respectively.

Conclusions: Fluorescein-guided technique with a dedicated filter on the surgical microscope is safe and allows a high-rate of complete resection of HGG at the early post-operative MRI.