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5-Aminolevulinic Acid-Guided Resection in Grade III Tumors-A Comparative Cohort Study
- Source :
- Operative neurosurgery (Hagerstown, Md.). 22(4)
- Publication Year :
- 2021
-
Abstract
- The benefits of using 5-aminolevulinic acid (5-ALA) in resection of grade IV tumors have been extensively researched. However, few studies have investigated the use of 5-ALA in grade III gliomas.To discover whether 5-ALA provides significant benefit in assisting resection of grade III gliomas.A single-center, retrospective cohort study between January 2013 and January 2019 of adult patients with grade III gliomas. Patients were separated into a 5-ALA-guided surgery group (5-ALA-GS) and non-5-ALA-guided surgery group (non-5-ALA-GS). Primary outcome was overall survival (OS); secondary outcomes were both postoperative and 6-month performance status (PS6m), and extent of resection (EoR).Sixty-nine patients with grade III gliomas were included (39 and 30 patients in the 5-ALA-GS group and non-5-ALA-GS group, respectively). There was no significant difference in tumor characteristics between the groups. No significant difference was observed in OS (P = .072) and EoR (P = .609) between both the groups. In a subgroup of the 5-ALA-GS where gross total resection (GTR) was achieved, there was a better OS (P = .043). Significantly worse outcomes were seen postoperatively (P = .044) and at PS6m (P = .041) in the 5-ALA-GS group, mainly because of the poorer outcome in the subtotal resection subgroup.Despite the benefits of 5-ALA in grade IV glioma surgery, these benefits are limited to a smaller group of patients with grade III tumors where there is sufficient fluorescence to allow GTR. In this cohort of patients, 5-ALA use may result in worse neurological outcomes particularly when GTR is not feasible and therefore caution is warranted.
Details
- ISSN :
- 23324260
- Volume :
- 22
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Operative neurosurgery (Hagerstown, Md.)
- Accession number :
- edsair.doi.dedup.....a7a384acfdd8ac5768aa5850f73dd82f