Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies.
<h4>Background</h4>We performed a systematic review and meta-analysis to address the (added) value of intraoperative 5-aminolevulinic acid (5-ALA)-guided resection of high-grade malignant gliomas compared with conventional neuronavigation-guided resection, with respect to diagnostic accu...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0063682 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839631139158884352 |
|---|---|
| author | Shiguang Zhao Jianing Wu Chunlei Wang Huailei Liu Xingli Dong Chen Shi Changbin Shi Yaohua Liu Lei Teng Dayong Han Xiaofeng Chen Guang Yang Ligang Wang Chen Shen Huadong Li |
| author_facet | Shiguang Zhao Jianing Wu Chunlei Wang Huailei Liu Xingli Dong Chen Shi Changbin Shi Yaohua Liu Lei Teng Dayong Han Xiaofeng Chen Guang Yang Ligang Wang Chen Shen Huadong Li |
| author_sort | Shiguang Zhao |
| collection | DOAJ |
| description | <h4>Background</h4>We performed a systematic review and meta-analysis to address the (added) value of intraoperative 5-aminolevulinic acid (5-ALA)-guided resection of high-grade malignant gliomas compared with conventional neuronavigation-guided resection, with respect to diagnostic accuracy, extent of tumor resection, safety, and survival.<h4>Methods and findings</h4>An electronic database search of Medline, Embase, and the Cochrane Library was undertaken. The review process followed the guidelines of the Cochrane Collaboration. 10 studies matched all selection criteria, and were thus used for qualitative synthesis. 5-ALA-guided resection demonstrated an overall sensitivity of 0.87 (95% confidence interval [CI], 0.81-0.92), specificity of 0.89 (95% CI, 0.79-0.94), positive likelihood ratio (LR) of 7.62 (95% CI, 3.87-15.01), negative LR of 0.14 (95% CI, 0.09-0.23), and diagnostic odds ratio (OR) of 53.06 (95% CI, 18.70-150.51). Summary receiver operating characteristic curves (SROC) showed an area under curve (AUC) of 94%. Contrast-enhancing tumor was completely resected in patients assigned 5-ALA as compared with patients assigned white light. Patients in the 5-ALA group had higher 6-month progression free survival and overall survival than those in the white light group.<h4>Conclusion</h4>Based on available literature, there is level 2 evidence that 5-ALA-guided surgery is more effective than conventional neuronavigation-guided surgery in increasing diagnostic accuracy and extent of tumor resection, enhancing quality of life, or prolonging survival in patients with high-grade malignant gliomas. |
| format | Article |
| id | doaj-art-db829d0e8c5f4d9daf6c18c59b2026d3 |
| institution | Matheson Library |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-db829d0e8c5f4d9daf6c18c59b2026d32025-07-12T05:31:25ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0185e6368210.1371/journal.pone.0063682Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies.Shiguang ZhaoJianing WuChunlei WangHuailei LiuXingli DongChen ShiChangbin ShiYaohua LiuLei TengDayong HanXiaofeng ChenGuang YangLigang WangChen ShenHuadong Li<h4>Background</h4>We performed a systematic review and meta-analysis to address the (added) value of intraoperative 5-aminolevulinic acid (5-ALA)-guided resection of high-grade malignant gliomas compared with conventional neuronavigation-guided resection, with respect to diagnostic accuracy, extent of tumor resection, safety, and survival.<h4>Methods and findings</h4>An electronic database search of Medline, Embase, and the Cochrane Library was undertaken. The review process followed the guidelines of the Cochrane Collaboration. 10 studies matched all selection criteria, and were thus used for qualitative synthesis. 5-ALA-guided resection demonstrated an overall sensitivity of 0.87 (95% confidence interval [CI], 0.81-0.92), specificity of 0.89 (95% CI, 0.79-0.94), positive likelihood ratio (LR) of 7.62 (95% CI, 3.87-15.01), negative LR of 0.14 (95% CI, 0.09-0.23), and diagnostic odds ratio (OR) of 53.06 (95% CI, 18.70-150.51). Summary receiver operating characteristic curves (SROC) showed an area under curve (AUC) of 94%. Contrast-enhancing tumor was completely resected in patients assigned 5-ALA as compared with patients assigned white light. Patients in the 5-ALA group had higher 6-month progression free survival and overall survival than those in the white light group.<h4>Conclusion</h4>Based on available literature, there is level 2 evidence that 5-ALA-guided surgery is more effective than conventional neuronavigation-guided surgery in increasing diagnostic accuracy and extent of tumor resection, enhancing quality of life, or prolonging survival in patients with high-grade malignant gliomas.https://doi.org/10.1371/journal.pone.0063682 |
| spellingShingle | Shiguang Zhao Jianing Wu Chunlei Wang Huailei Liu Xingli Dong Chen Shi Changbin Shi Yaohua Liu Lei Teng Dayong Han Xiaofeng Chen Guang Yang Ligang Wang Chen Shen Huadong Li Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. PLoS ONE |
| title | Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. |
| title_full | Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. |
| title_fullStr | Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. |
| title_full_unstemmed | Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. |
| title_short | Intraoperative fluorescence-guided resection of high-grade malignant gliomas using 5-aminolevulinic acid-induced porphyrins: a systematic review and meta-analysis of prospective studies. |
| title_sort | intraoperative fluorescence guided resection of high grade malignant gliomas using 5 aminolevulinic acid induced porphyrins a systematic review and meta analysis of prospective studies |
| url | https://doi.org/10.1371/journal.pone.0063682 |
| work_keys_str_mv | AT shiguangzhao intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT jianingwu intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT chunleiwang intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT huaileiliu intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT xinglidong intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT chenshi intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT changbinshi intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT yaohualiu intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT leiteng intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT dayonghan intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT xiaofengchen intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT guangyang intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT ligangwang intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT chenshen intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies AT huadongli intraoperativefluorescenceguidedresectionofhighgrademalignantgliomasusing5aminolevulinicacidinducedporphyrinsasystematicreviewandmetaanalysisofprospectivestudies |