ArticleJournal of neuro-oncology2019
Is 5-ALA fluorescence of cerebral metastases a prognostic factor for local recurrence and overall survival?
Article in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 32 citations in OpenAlex.
- Epidemiology and palliative care of in-patient cerebral metastases cases in Germany.Journal of neuro-oncology · 2025Article
- Fluorescence-Guided Surgery Using 5-Aminolevulinic Acid/Protoporphyrin IX in Brain Metastases.Neurosurgery practice · 2024Review
- Pharmaceutical equivalent 5-aminolevulinic acid fluorescence guided resection of central nervous system tumors: feasibility, safeness and cost-benefit considerations.Journal of neuro-oncology · 2024Article
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- Opportunities and Alternatives of Modern Radiation Oncology and Surgery for the Management of Resectable Brain Metastases.Cancers · 2023Review
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- Prognostic factors following resection of intracranial metastases.Surgical neurology international · 2022Article
- Surgical advances in the management of brain metastases.Neuro-oncology advances · 2021Article
- Second window ICG predicts gross-total resection and progression-free survival during brain metastasis surgery.Journal of neurosurgery · 2021Article
- Article
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- Neurosurgery for brain metastasis from breast cancer.Translational cancer research · 2020Review
- Experience Profiling of Fluorescence-Guided Surgery II: Non-Glioma Pathologies.Brain tumor research and treatment · 2019Article
- Quantification of PpIX-fluorescence of cerebral metastases: a pilot study.Clinical & experimental metastasis · 2019Article
- Established and emerging uses of 5-ALA in the brain: an overview.Journal of neuro-oncology · 2019Review
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background5-Aminolevulinic acid (5-ALA) fluorescence-guided resection technique was first introduced for malignant glioma. However, the impact of the 5-ALA fluorescence behaviour of cerebral metastases is still unclear. Aim of this study was to determine the impact of PpIX-fluorescence on the local progression-free and overall survival. MATERIALS AND
methodsA secondary analysis was performed and included an updated follow-up of 136 patients comprised in two previous studies. Additionally, 82 new patients were included. All patients underwent surgical resection of cerebral metastasis and intraoperative estimation of 5-ALA-induced fluorescence. The 5-ALA fluorescence behaviour of cerebral metastases was correlated with the rate of local recurrences, the local progression-free and overall survival.
results218 patients suffering from cerebral metastatic spread fulfilled the inclusion criteria and were analysed: complete surgical resection could be achieved in 123/218 patients (56.4%). Dichotomised degree of surgical resection (complete vs. incomplete or questionable complete resection) was not related to dichotomized 5-ALA fluorescence of cerebral metastases (p = 0.66). 51 patients (23.4%) developed a local in-brain progression within or at the border of the resection cavity. Of these, 8 patients showed a PpIX-fluorescent metastasis. There was a trend towards a correlation between a higher local in-brain progression in PpIX-non-fluorescent metastases (p = 0.03). Median time to local in-brain progression was 4 ± 11 months. PpIX-fluorescent and PpIX-non-fluorescent metastases showed a significantly different progression-free survival (p = 0.01). PpIX-positive and -negative metastases showed a significantly different overall survival (20 and 14 months respectively; p = 0.006).
conclusionThe 5-ALA fluorescence behaviour was related to the local progression-free and the overall survival in the present retrospective series and might be considered a prognostic marker. Further studies are required to appreciate the oncological impact of the 5-ALA induced fluorescence behaviour of cerebral metastases.
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