ReviewFrontiers in oncology2021
Rationale and Clinical Implications of Fluorescein-Guided Supramarginal Resection in Newly Diagnosed High-Grade Glioma.
Review in Frontiers in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Shining a light on brain tumors: a review of Raman spectroscopy in the operating room.Journal of biomedical optics · 2026Review
- Comparison of Fluorescent Probes for IDH-Wildtype Glioblastoma, Metastatic Brain Tumors, and PCNSL: A Biomechanical Perspective.International journal of molecular sciences · 2026Review
- Review
- A novel near-infrared II viscosity-responsive probe for surgical fluorescence guidance: laboratory investigation in a murine subcutaneous glioma model.Frontiers in oncology · 2026Article
- Epidemiological characteristics and prognostic factors of high-grade brainstem glioma for all ages and the establishment of a nomogram.Translational cancer research · 2025Article
- Confocal Laser Endomicroscopy: Enhancing Intraoperative Decision Making in Neurosurgery.Diagnostics (Basel, Switzerland) · 2025Review
- Quantitative assessment of residual tumor is a strong and independent predictor of survival in methylated glioblastoma following radiochemotherapy with lomustine/temozolomide.Neuro-oncology · 2025Article
- Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience.Brain sciences · 2025Article
- Fluorescein-guided surgery in high-grade gliomas: focusing on the eloquent and deep-seated areas.Journal of cancer research and clinical oncology · 2024Article
- Case report: Giant meningioma of the left hemisphere.Frontiers in oncology · 2024Article
- Systematic Review of WHO Grade 4 Astrocytoma in the Cerebellopontine Angle: The Impact of Anatomic Corridor on Treatment Options and Outcomes.Journal of neurological surgery reports · 2023Article
- Transcranial Photosensitizer-Free Laser Treatment of Glioblastoma in Rat Brain.International journal of molecular sciences · 2023Article
- Supramaximal Resection for Glioblastoma: Redefining the Extent of Resection Criteria and Its Impact on Survival.Brain tumor research and treatment · 2023Review
- Same but different. Incidental and symptomatic lower grade gliomas show differences in molecular features and survival.Journal of neuro-oncology · 2023Article
- Article
- Low-Level Laser Treatment Induces the Blood-Brain Barrier Opening and the Brain Drainage System Activation: Delivery of Liposomes into Mouse Glioblastoma.Pharmaceutics · 2023Article
- Maximal Safe Resection in Glioblastoma Surgery: A Systematic Review of Advanced Intraoperative Image-Guided Techniques.Brain sciences · 2023Review
- Fluorescein-guided surgery for high-grade glioma resection: a five-year-long retrospective study at our institute.Frontiers in oncology · 2023Article
- Comparison of anatomical-based vs. nTMS-based risk stratification model for predicting postoperative motor outcome and extent of resection in brain tumor surgery.NeuroImage. Clinical · 2023Article
- Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors.
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Abstract
Current standard of care for glioblastoma is surgical resection followed by temozolomide chemotherapy and radiation. Recent studies have demonstrated that >95% extent of resection is associated with better outcomes, including prolonged progression-free and overall survival. The diffusely infiltrative pattern of growth in gliomas results in microscopic extension of tumor cells into surrounding brain parenchyma that makes complete resection unattainable. The historical goal of surgical management has therefore been maximal safe resection, traditionally guided by MRI and defined as removal of all contrast-enhancing tumor. Optimization of surgical resection has led to the concept of supramarginal resection, or removal beyond the contrast-enhancing region on MRI. This strategy of extending the cytoreductive goal targets a tumor region thought to be important in the recurrence or progression of disease as well as resistance to systemic and local treatment. This approach must be balanced against the risk of impacting eloquent regions of brain and causing permanent neurologic deficit, an important factor affecting overall survival. Over the years, fluorescent agents such as fluorescein sodium have been explored as a means of more reliably delineating the boundary between tumor core, tumor-infiltrated brain, and surrounding cortex. Here we examine the rationale behind extending resection into the infiltrative tumor margins, review the current literature surrounding the use of fluorescein in supramarginal resection of gliomas, discuss the experience of our own institution in utilizing fluorescein to maximize glioma extent of resection, and assess the clinical implications of this treatment strategy.
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