gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Sodium fluorescein and YELLOW 560 nm filter for resection of newly diagnosed glioblastoma – impact on resection quality and outcome

Natrium Fluoreszein und YELLOW 560 nm Filter für die Resektion neu diagnostizierter Glioblastome: Einfluss auf Resektionsausmaß und Outcome

Meeting Abstract

  • presenting/speaker Karl-Michael Schebesch - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Julius Höhne - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Christian Doenitz - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Katharina Rosengarth - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Nils-Ole Schmidt - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Martin Proescholdt - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV090

doi: 10.3205/22dgnc093, urn:nbn:de:0183-22dgnc0931

Veröffentlicht: 25. Mai 2022

© 2022 Schebesch 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: Maximal surgical resection of glioblastoma (GBM) has been demonstrated to improve progression–free survival and overall survival. Recently, fluorescein sodium in combination with the YELLOW 560 nm filter (Carl Zeiss Meditec, Germany) (FY) has been introduced as a safe and feasible method to visualize residual tumor tissue during GBM resection. We hypothesized that the use FY may positively influence the volumetric extent of resection and the overall survival in patients who undergo surgical resection of a newly diagnosed GBM.

Methods: From a prospective GBM registry, a cohort of 347 patients (median age 62.4 years; female/male ratio 141/206) was selected from which high quality preoperative magnetic resonance imaging (MRI) was available for volumetric analysis. Resection was performed without FY support in 151 (43.5%; group A) and with FI support in 196 (56.5%; group B) patients. Gender, age, presurgical Karnofsky Performance Index (KPI), MGMT status and adjuvant treatment modalities were well balanced between the groups. Volumetric analysis was performed using Brainlab iPlan cranial software by quantifying pre- and postoperative tumor volume, based on the gadolinium-enhanced T1 sequences.

Results: The preoperative volume of group A was moderately larger compared to group B (p=0.063). The postoperative tumor volume and the residual volume as percentage of the initial tumor size was significantly smaller in group B. Accordingly, the quantitative extent of resection was significantly larger in group B (p=0.003). Of group B, significantly more complete resections were achieved compared to group A (p=0.003). Surgical mortality and morbidity were not significantly different between the groups (p=0.545 and 0.314 respectively). Overall survival was significantly longer in group B (p=0.015, log rank testing). Multivariate Cox regression modelling revealed age, presurgical KPI, MGMT status and FY supported resection as independent prognostic factors for survival.

Conclusion: FY supported resection of newly diagnosed GBM results in improved extent of resection and prolonged overall survival.