scholarly journals Survival Outcomes Among Patients With High-Grade Glioma Treated With 5-Aminolevulinic Acid–Guided Surgery: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 9 ◽  
Author(s):  
Sirin Gandhi ◽  
Ali Tayebi Meybodi ◽  
Evgenii Belykh ◽  
Claudio Cavallo ◽  
Xiaochun Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aminolevulinic Acid ◽  
Meta Analysis ◽  
High Grade Glioma ◽  
Survival Outcomes ◽  
High Grade ◽  
Guided Surgery

scholarly journals PDCT-17. SURVIVAL OUTCOMES IN PEDIATRIC RECURRENT HIGH-GRADE GLIOMA: RESULTS OF A 20-YEAR SYSTEMATIC REVIEW AND META-ANALYSIS

2017 ◽  
Vol 19 (suppl_6) ◽  
pp. vi187-vi187
Author(s):  
Cassie Kline-Nunnally ◽  
Erin Felton ◽  
Elaine Allen ◽  
Peggy Tahir ◽  
Sabine Mueller
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
High Grade Glioma ◽  
Survival Outcomes ◽  
High Grade

scholarly journals HGG-08. SURVIVAL OUTCOMES OF PEDIATRIC HIGH-GRADE GLIOMA: RESULTS OF A 20-YEAR SYSTEMATIC REVIEW AND META-ANALYSIS

2017 ◽  
Vol 19 (suppl_4) ◽  
pp. iv24-iv24
Author(s):  
Cassie Kline ◽  
Erin Felton ◽  
Isabel Allen ◽  
Peggy Tahir ◽  
Sabine Mueller
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
High Grade Glioma ◽  
Survival Outcomes ◽  
High Grade ◽  
Pediatric High Grade Glioma

scholarly journals Survival outcomes in pediatric recurrent high-grade glioma: results of a 20-year systematic review and meta-analysis

2017 ◽  
Vol 137 (1) ◽  
pp. 103-110 ◽  
Author(s):  
Cassie Kline ◽  
Erin Felton ◽  
I. Elaine Allen ◽  
Peggy Tahir ◽  
Sabine Mueller
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
High Grade Glioma ◽  
Survival Outcomes ◽  
High Grade

scholarly journals SURG-32. THE USE OF 5-AMINOLEVULINIC ACID IN LOW-GRADE GLIOMA RESECTION: A SYSTEMATIC REVIEW

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi246-vi246
Author(s):  
Ahmad Almekkawi ◽  
Tarek El Ahmadieh ◽  
Karl Abi-Aad ◽  
Salah Aoun ◽  
Najib EL Tecle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Index ◽  
Aminolevulinic Acid ◽  
High Grade Glioma ◽  
Extent Of Resection ◽  
Low Grade Glioma ◽  
Low Grade ◽  
High Grade ◽  
Visualization Technology ◽  
Glioma Resection

Abstract BACKGROUND 5-aminolevulinic acid is a reliable tool for optimizing high-grade glioma resection. However, its efficacy in low-grade glioma resection remains unclear. OBJECTIVE To study the role of 5-aminolevulinic acid in low-grade glioma resection and assess positive fluorescence rates and effect on the extent of resection. METHODS A systematic review of PubMed, Google Scholar, and Cochrane was performed from the date of inception to February 1, 2019. Studies that correlated 5-aminolevulinic acid fluorescence with low-grade glioma in the setting of operative resection were selected. Studies with biopsy only were excluded. Positive fluorescence rates were calculated. Quality index of the selected papers using the Downs and Black criteria checklist was provided. RESULTS Twelve articles met the selection criteria with 244 histologically-confirmed low-grade glioma patients who underwent microsurgical resection. All patients received 20 mg/kg body weight of 5-aminolevulinic acid. Only 60 patients (n=60/244; 24.5%) demonstrated visual intra-operative 5-aminolevulinic acid fluorescence. The extent of resection was reported in 4 studies, however, the data combined low- and high-grade tumors. Only 2 studies reported on tumor location. Only 3 studies reported on clinical outcomes. The Zeiss OPMI Pentero microscope was most commonly used across all studies. The average quality index was 14.58 (range: 10–17) which correlated with an overall good quality. CONCLUSION There is an overall low correlation between 5-aminolevulinic acid fluorescence and low-grade glioma. Advances in visualization technology and using standardized fluorescence quantification methods may further improve the visualization and reliability of 5-aminolevulinic acid fluorescence in low-grade glioma resection.

scholarly journals Intraoperative 5-ALA Fluorescence-Guided Resection of High-Grade Glioma Leads to Greater Extent of Resection with Better Outcomes: A Systematic Review

2021 ◽  
Author(s):  
Tiffany Eatz ◽  
Daniel Eichberg ◽  
Victor Lu ◽  
Long Di ◽  
Ricardo Jorge Komotar ◽  
...  
Keyword(s):  
Systematic Review ◽  
White Light ◽  
Randomized Clinical Trials ◽  
Aminolevulinic Acid ◽  
High Grade Glioma ◽  
Extent Of Resection ◽  
Fluorescent Imaging ◽  
Neurological Deficits ◽  
High Grade ◽  
Significant Difference

Abstract ImportanceHigh-grade gliomas (HGG) are the most aggressive and common malignant brain tumors in adults. They have a dismally fatal prognosis. Even if gross total resection of the enhancing tumor is achieved, inevitably, invading tumor cells that are indistinguishable to the un-aided eye are left behind, which eventually leads to tumor recurrence. 5-aminolevulinic acid (5-ALA) is an increasingly utilized intraoperative fluorescent imaging agent for patients with HGG. It enhances visualization of HGG tissue. Despite early promising randomized clinical trial data suggesting a survival benefit for 5-ALA-guided surgery, the growing body of literature must be analyzed to confirm efficacy on patient outcomes.Objective To perform a systematic review of the literature to evaluate whether there is a beneficial effect upon survival and extent of resection due to the utilization of 5-ALA in HGG surgery. Evidence ReviewLiterature regarding 5-ALA usage in HGG surgery was reviewed according to the PRISMA guidelines. One database, PubMed, was searched for assorted combinations of the keywords “5-ALA,” “high-grade glioma,” “5-aminolevulinic acid,” and “resection” in July 2020 for case reports and retrospective, prospective, and randomized clinical trials assessing and analyzing 5-ALA intraoperative use in patients with HGG. Entailed studies on PubMed and SCOPUS were found for screening using a snowball search technique upon the initially searched PubMed papers. Systematic reviews and meta-analyses were excluded from our PRISMA table. Findings1,951 previously published studies were screened, 536 of which were further evaluated, and ultimately 45 were included in our systematic review. There were no date restrictions on the screened publications. Our literature search was finalized on July 16, 2020. We found an observed increase in the overall survival (OS) and progression-free survival (PFS) of the 5-ALA group compared to the white light group, as well as an observed increase in the OS and PFS of complete resections compared to incomplete resections. Of the studies that directly compared the use of 5-ALA to white light (13 of the total analyzed 45, or 28.9%), 5-ALA lead to a better PFS and OS in 88.4% and 67.5% of patients, respectively. When the studies that reported postoperative neurologic outcomes of surgeries using 5-ALA vs. white light were analyzed, 42.2% of subjects demonstrated 5-ALA use was associated with less post-op neurological deficits, whereas 34.5% demonstrated no statistically significant difference between 5-ALA and without. 23.3% of studies showed that intraoperative 5-ALA guided surgeries lead to more post-op neurological deficits. Conclusions and RelevanceUtilization of 5-ALA was found to be associated with a greater extent of resection in HGG surgeries, as well as longer OS and PFS. Postop neurologic deficit rates were mixed and inconclusive when comparing 5-ALA groups to white light groups. 5-ALA is a useful surgical adjunct for resection of HGG when patient safety is preserved.

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