Fluorescence vs. Conventional Surgery for High-Grade Glioma: 7-Year Study
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Fluorescence-Guided versus Conventional Surgical Resection of High Grade Glioma: A Single-Centre, 7-Year, Comparative Effectiveness Study
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Wei Ping Ng, Boon Seng Liew, Zamzuri Idris, Azmin Kass Rosman
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Fluorescence-Guided versus Conventional Surgical Resection of High Grade Glioma: A Single-Centre, 7-Year, Comparative Effectiveness Study
Year: 2017 | Doi: 10.21315/mjms2017.24.2.10
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
High-grade gliomas (HGGs), particularly glioblastoma multiforme (GBM) and anaplastic astrocytoma (AA), represent some of the most aggressive and common primary brain tumors in adults, presenting significant treatment challenges and poor prognosis. Surgical resection, often coupled with radiotherapy and chemotherapy, is the standard treatment strategy. The complexity of these tumors, particularly their invasive nature, complicates complete resection without causing neurological deficits. To address this issue, the Department of Neurosurgery at Hospital Sungai Buloh in Malaysia implemented fluorescence-guided (FG) surgery using 5-aminolevulinic acid (5-ALA) to enhance intraoperative identification of tumor margins.
Enhanced Surgical Outcomes with Fluorescence-Guided Surgery
The use of fluorescence-guided surgery not only improves the visual delineation of tumor borders but also significantly impacts patient outcomes. In a cohort study involving 74 patients with histologically confirmed HGGs, those undergoing FG surgery demonstrated markedly longer median survival rates (12 months) compared to conventional surgical methods (8 months). Additionally, even in cases where no adjuvant therapy was given, patients in the FG group survived an average of 8 months, contrasting with just 3 months for the conventional group. The study identified key predictors of survival, including pre-operative Karnofsky performance score (KPS), histology, surgical method, and the use of adjuvant therapy. The results suggest that FG surgery offers a clinically significant advantage in extending survival while preserving functional outcomes post-surgery.
Conclusion
This investigation underscores the vital role of fluorescence-guided surgery in improving the prognosis for patients with high-grade gliomas. By facilitating more complete tumor resections, FG surgery has emerged as a promising technique that does not compromise postoperative functionality, thus enhancing patient survival rates. The findings advocate for broader implementation of this technique within local medical practice, while also highlighting the need for further multicentred randomized controlled trials to substantiate these results and establish FG surgery as a standard component of HGG management. This study contributes valuable evidence toward improving treatment outcomes for HGG patients in Malaysia and potentially worldwide.
FAQ section (important questions/answers):
What are high grade gliomas and their prognosis?
High grade gliomas (HGGs) are aggressive, locally invasive brain tumors with a poor prognosis, particularly glioblastoma multiforme, which has a median survival of 12 months.
How does fluorescence-guided surgery assist in glioma treatment?
Fluorescence-guided surgery using 5-ALA helps neurosurgeons visualize tumor margins better, improving the likelihood of complete tumor resection and potentially extending patient survival.
What were the survival outcomes for patients in the study?
Patients undergoing fluorescence-guided surgery had a median survival of 12 months, compared to 8 months for those who had conventional surgery, indicating a significant benefit from the FG approach.
What factors were identified as predictors of survival in HGG patients?
Key predictors included higher pre-operative Karnofsky performance score, histology type, surgical method, and whether patients received adjuvant therapy, emphasizing the importance of these factors in managing HGG.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Fluorescence vs. Conventional Surgery for High-Grade Glioma: 7-Year Study”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In the context of scientific research, 'table' refers to a structured arrangement of data displaying key findings from a study in a concise manner. Tables help readers easily compare numbers, trends, or characteristics, which are crucial for interpreting outcomes. The included tables present important metrics on patient demographics, treatment methods, and survival rates that inform the study's conclusions.
2) Study (Studying):
A 'study' is a systematic investigation aimed at discovering new information or confirming previous findings. In medical research, studies help evaluate the effectiveness of treatments, like fluorescence-guided surgery in high-grade gliomas. Through a retrospective cohort analysis, this study provides valuable insights into survival rates and functional outcomes, guiding future treatment protocols.
3) Post:
'Post' relates to events or conditions following a specific occurrence, such as surgery. In clinical research, postoperative assessments are crucial for evaluating recovery and treatment effectiveness. In this study, evaluations of patient outcomes were conducted post-surgery at intervals, helping to determine the impact of surgical methods on recovery and survival.
4) Radiotherapy:
Radiotherapy is a cancer treatment that uses high-energy particles to destroy cancer cells. It is commonly combined with surgery and chemotherapy in high-grade glioma treatment protocols. Understanding its role in patient survival outcomes is critical, as this study highlights how adjuvant therapies, including radiotherapy, impact overall survival rates and patient quality of life.
5) Male:
In the context of this study, 'male' refers to the gender classification of patients involved. Gender may influence health risks, treatment outcomes, and survival rates. This study provides demographic breakdowns showing a higher prevalence of high-grade gliomas in males, helping to identify potential trends and focus on gender-specific treatment approaches.
6) Performance:
Performance in a medical context, often measured by scales like the Karnofsky Performance Scale (KPS), reflects a patient's functional status. In this study, KPS was utilized to assess patient wellbeing pre- and post-surgery, providing insights into how surgical methods affect overall functionality and quality of life after treatment for high-grade gliomas.
7) Rules:
'Rules' can refer to guidelines or protocols governing clinical practices and research methodologies. In the context of this study, adherence to ethical and scientific standards ensures the reliability of findings and the integrity of data collection, which is vital for drawing accurate conclusions about treatment efficacy and patient outcomes.
8) Chemotherapy:
Chemotherapy involves the use of drugs to treat cancer by killing rapidly dividing cells. In high-grade glioma treatment, it is often used alongside surgery and radiotherapy. The study explores the survival impact of adjuvant chemotherapy, demonstrating its critical role in enhancing the effectiveness of primary surgical interventions.
9) Sanai (Shanai):
Sanai refers to a specific researcher or author who may have contributed significant insights or findings in the field of neuro-oncology or glioma treatment. Citing established researchers enhances credibility and connects current findings with established knowledge, providing a foundation for the importance of surgery and treatment strategies discussed in the study.
10) Relative:
The term 'relative' is often used in medical research to discuss risk factors or survival rates in comparison to a baseline or control group. In this study, relative risks associated with different treatments, such as conventional versus fluorescence-guided surgery, inform on the effectiveness and potential outcomes for patients with high-grade gliomas.
11) Death:
'Death' is a crucial endpoint in medical studies, often used to evaluate treatment effectiveness and patient prognosis. In this research, tracking mortality rates among high-grade glioma patients post-treatment helps assess surgical methods' long-term effects, guiding future clinical practices and prioritizing interventions that improve survival.
12) Keshari (Kesari, Kesha-ari):
Kesari is likely referenced as an author in the published literature regarding glioma research. Notable authors lend credibility to studies, often based on previous findings or theories, ensuring ongoing conversations in cancer research. In this context, their contributions underscore the complexity and advancements in glioma treatment approaches.
13) Cancer:
'Cancer' is a disease characterized by the uncontrolled growth of abnormal cells. Understanding cancer types, treatment modalities, and patient responses is vital in medical research. This study focuses on high-grade gliomas, a severe form of brain cancer, emphasizing the necessity for effective surgical techniques and comprehensive treatment regimens to improve patient outcomes.
14) Egypt:
In a research context, 'Egypt' could refer to a geographic location with specific epidemiological data or clinical practices concerning cancer treatment. Notably, different regions may exhibit varying incidences of diseases like glioma, thus understanding these geographic factors is essential for developing targeted treatment approaches and enhancing global cancer care.
15) Mason:
Mason might refer to a significant contributor to the literature or research on glioblastoma or cancer therapies, establishing connections between various studies. Citing recognized researchers enhances the legitimacy of findings reported, fostering advancements in understanding the prognosis and treatment approaches for malignant conditions like high-grade gliomas.
16) Kamar:
Kamar could indicate another researcher whose work contributes to the understanding of glioma treatment and outcomes. Prominent names within research help to build a robust framework for exploring patient outcomes, emphasizing the collaboration and shared knowledge that advance oncology and improve treatment efficacy among cancer patients.
17) Visit:
The term 'visit' relates to patient follow-ups in a clinical setting post-treatment. Regular visits allow for monitoring health changes and assessing the effectiveness of interventions over time, which is essential in evaluating the longevity of surgical results and overall health status in patients recovering from high-grade glioma surgeries.
18) Kani:
Kani might refer to a relevant author or researcher in the field, contributing to the discourse around glioma treatment strategies. Contributions from named individuals signify collaborative efforts in advancing medical knowledge and addressing clinical challenges encountered in the management and treatment of serious conditions like glioblastoma.
19) Life:
'Life' in a medical context often pertains to the survival and quality of life of patients undergoing treatment. This study evaluates survival rates and how different factors, including surgical interventions, impact life expectancy in patients with high-grade gliomas, providing critical insights into optimizing treatment protocols for better patient outcomes.
20) Accumulation (Accumulating, Accumulate):
Accumulation in biological terms often refers to the build-up of substances, such as fluorescent agents, within cells. In this study, the accumulation of protoporphyrin IX from 5-ALA aids in the enhanced visualization of tumor margins during surgery, which can improve the efficacy of tumor resections and overall patient survival.
21) Surrounding:
'Surrounding' typically refers to the area adjacent to a tumor, critical in the context of gliomas where tumors invade surrounding brain tissue. Understanding how tumors interact with their environment is vital for strategizing surgical removal and assessing how different methods influence postoperative recovery and survival signals.
22) Discussion:
'Discussion' refers to the section in academic writing where results are interpreted, and their implications explored. This section allows authors to contextualize findings, compare with existing literature, and suggest future research directions, playing a crucial role in advancing knowledge in high-grade glioma treatment strategies.
23) Nature:
In medical research, 'nature' might refer to the intrinsic characteristics of a disease. In this study, recognizing the nature of high-grade gliomas—such as their aggressive growth patterns and infiltrative behavior—is crucial for developing effective surgical and adjuvant therapies tailored to combat these debilitating conditions.
24) Drug:
A 'drug' in a medical context refers to a substance utilized for treatment, prevention, or diagnosis of diseases. This study discusses the role of drugs like temozolomide in conjunction with surgery for treating high-grade gliomas, highlighting how pharmacological interventions can significantly influence patient survival rates.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Fluorescence vs. Conventional Surgery for High-Grade Glioma: 7-Year Study’. Further sources in the context of Science might help you critically compare this page with similair documents:
Observational study, Multivariate analysis, Limitations of the study, Surgical resection, Adjuvant therapy, Functional outcome, Chemotherapy and Radiotherapy, Functional status, Statistically significant difference, Magnetic resonance imaging, Surgical technique, Clinical outcome, Retrospective cohort study, Clinical benefit, Overall survival, Prognostic Factor, Histological grade, Tumour volume, Median survival time, Glioblastoma multiforme, Progression-free survival, Surgical method, Phase III trial, Motor deficit, Department of Neurosurgery, Ministry of Health, Brain tumour, Complete resection, Frequency of occurrence, Surgical time, Post operative complication, Median survival, Patient factor, Anaplastic astrocytoma, National Institute of Health, Authors contribution, High-grade glioma.