Clinical study of sodium fluorescein guided technique in treatment of brain metastases
Objective To investigate whether the use of sodium fluorescein would increase the extent of resection of brain metastases,and to examine whether the resection guided by sodium fluorescein would affect the postoperative neurological status and have a positive effect on the postoperative prognosis.Methods A retrospective analysis was conducted on the data of patients with brain metastases who underwent surgical resection at the Department of Neurosurgery,Inner Mongolia People's Hospital from January 2016 to August 2023.A total of 84 patients were enrolled.There were 45 cases in the sodium fluorescein guided group treated with sodium fluorescein microscope to remove the tumor and 39 cases in the non-sodium fluorescein guided group removed under the traditional white light microscope.MRI was performed within 72 hours after surgery in all patients.Preoperative and postoperative T1-enhanced MRI were used to evaluate the extent of resection.We then analyzed the differences in the Karnofsky Performance Status Scores(KPS)3 months after surgery,local recurrence rates and survival rates 1 year after surgery between the two groups of patients.Results There were no statistically significant differences in baseline data such as gender,age,preoperative KPS,and location of brain metastases between the two groups of patients(all P＞0.05),indicating that the two groups were comparable.Surgeries were successfully completed for all patients in both groups.Early-stage postoperative MRI showed that among the 45 patients in the observation group,33 cases(73.3％)had no tumor residue,9 cases(20.0％)had no measurable tumor residue,and 3 cases(6.7％)had measurable tumor residue;among the 39 patients in the control group,21 cases(53.8％)had no tumor residue,9 cases(23.1％)had no measurable tumor residue,and 9 cases(23.1％)had measurable tumor residue.Compared with the control group,the proportion of patients with no tumor residue after surgery was higher in the observation group(P=0.037).Compared with the control group,the KPS of patients in the observation group was higher at 3 months after surgery(86.60±9.16 points vs.82.12±7.50 points),and 1-year local recurrence rate was lower[8.9％(4/45)vs.25.6％(10/39)],and the differences were statistically significant(both P＜0.05).However,there was no statistically significant difference in the 1-year survival rate between the two groups[51.1％(23/45)vs.38.5％(15/39),P=0.245].Conclusion Fluorescein sodium-guided surgery can help improve the resection extent of brain metastases and reduce the local recurrence rate of tumors,while it does not seem to improve the one-year survival rate of patients.
Brain neoplasmsMetastasectomyTreatment outcomeFluorescence-guided surgeryExtent of resection
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