Topics

Evaluation of Resection Quality of Cerebral Metastases Using Fluorescence Guided Surgery: a Prospective Randomised Study

2019-10-10 09:39:29 | BioPortfolio

Summary

Few studies have evaluated the use of fluorescein sodium for the resection of brain tumours (especially glioblastomas) but also cerebral metastases. We therefore propose to evaluate the technique of fluorescence guided microsurgery (fluorescein sodium) compared to the conventional microsurgical technique in the resection of cerebral metastases in adults in order to specify, by a prospective and randomised study, the assistance provided by this technique in the quality of resection and the gain in terms of overall survival and local control of brain disease.

Description

Cerebral metastases are a major public health problem in cancer patients. They are the most common brain tumours in adults. It is estimated that approximately 20-40% of patients with primary malignant neoplasia will develop cerebral metastasis during the course of their illness. In addition, the incidence of brain metastases is increasing due, in particular, to the aging of the population, as well as to the improvement of the overall management of cancer patients (cytotoxic or targeted systemic treatment) and easier access to magnetic resonance imaging (MRI), which improves patient survival. The prognosis of patients with brain metastases is still poor and the median overall survival of these patients is of the order of a few months. Although the management of brain metastases is multidisciplinary, the benefit of surgery has been clearly demonstrated in the literature. Consequently, it is demonstrated that the quality of the tumour excision and in particular the carrying out of the complete excision of contrast enhancement on the MRI is correlated with improved overall survival (especially in case of single metastasis) and improved local control of the disease or progression-free survival, but also a better quality of life. It is therefore essential to perform the most complete excision possible while minimising the associated morbidity. For this purpose, various tools for surgical resection have been developed and are available, including intraoperative fluorescence guided surgery. Sodium fluorescein is a fluorochrome that accumulates, after intravenous injection, into vascularised tumour tissues and is revealed intraoperatively by a light source of suitable wavelength (560 nm) using a set of lenses included in the microscope. The resection is thus guided by this fluorescence, the complete disappearance of which will translate into a complete tumour resection. Its interest is twofold: to increase the percentage of complete tumour resection and to improve survival without recurrence and overall survival.Few studies have evaluated the use of fluorescein sodium for the resection of brain tumours (especially glioblastomas) but also cerebral metastases. If two studies on brain metastases showed a complete resection rate greater than 80% and a better rate of local control of brain disease, it is important to note that these studies were not randomised (with a control arm), they did not really prove the effectiveness of this technique under fluorescence, hence the need to set up a randomised study. We therefore propose to evaluate the technique of fluorescence guided microsurgery (fluorescein sodium) compared to the conventional microsurgical technique in the resection of cerebral metastases in adults in order to specify, by a prospective and randomised study, the assistance provided by this technique in the quality of resection and the gain in terms of overall survival and local control of brain disease.

Study Design

Conditions

Cerebral Metastases

Intervention

microsurgical resection

Location

Clairval Private Hospital
Marseille
Paca
France
13009

Status

Recruiting

Source

Ramsay Générale de Santé

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-10-10T09:39:29-0400

Clinical Trials [2019 Associated Clinical Trials listed on BioPortfolio]

Cavity Boost Radiation Therapy vs. Observation in Cerebral Metastases After Complete Surgical Resection

The purpose of this study is to determine whether a local fractionated radiation therapy achieves a better local tumor control after complete surgical metastases resection at 6 month as co...

Endocrine Outcome of Surgery for Pituitary Adenoma

Prospective and randomized compare between microsurgical and endoscopic transsphenoidal MRI assisted resection of pituitary adenomas.

Study of Resection Combined With Stereotactic Radiosurgery for 1 to 3 Brain Metastases

This study is to look more closely at the tumor removed during your surgery, and to follow your condition after your treatment. The purpose of this study is to determine what side effects...

Resection of Colorectal Liver Metastases With or Without Routine Hilar Lymphadenectomy

It is uncertain, whether hilar lymphadenectomy should be performed routinely in patients undergoing resection of colorectal liver metastases. For this reason it is the aim of the present ...

Effect of Sirolimus on Molecular Alterations in Cerebral Aneurysms

The objective of this study is to explore the effects of Sirolimus on the underlying molecular alterations of cerebral aneurysms.

PubMed Articles [3941 Associated PubMed Articles listed on BioPortfolio]

Microsurgical Anatomy and Approaches to the Cerebral Central Core.

The main objective of this work is, through the cadaveric study, to divide the cerebral central core in different areas, and propose the corresponding neurosurgical approach for each sector, providing...

Glioblastoma presenting as spontaneous subarachnoid hemorrhage: a technical case note of combined endovascular and microsurgical vision sparing treatment.

Clinical utility of endovascular adjunct for tumor resection is well established, but its role in acute subarachnoid hemorrhage (SAH) secondary to neoplastic pseudo aneurysm rupture has not been repor...

An analysis of clinical efficacy of microsurgical resection of intradural neoplasm by unilateral approach with Caspar retractors.

This study aims to investigate the clinical efficacy of minimally invasive microsurgical resection of intraspinal tumors with the aid of Caspar retractors.

Extended Molecular Profiling Improves Stratification and Prediction of Survival After Resection of Colorectal Liver Metastases.

The aim of this study was to assess the effect of cancer-related genes and their mutations analyzed by next-generation sequencing (NGS) on the oncological outcome after resection of colorectal liver m...

Application of intraoperative FLOW 800 ICG videoangiography colour coded maps for microsurgical clipping of intracranial aneurysms.

Indocyanine green (ICG) videoangiography (VAG) is an established method for assessment of cerebral blood flow during microsurgical clipping of intracranial aneurysms. FLOW 800 is a surgical microscope...

Medical and Biotech [MESH] Definitions

Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.

Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA.

Irradiation of one half or both halves of the body in the treatment of disseminated cancer or widespread metastases. It is used to treat diffuse metastases in one session as opposed to multiple fields over an extended period. The more frequent treatment modalities are upper hemibody irradiation (UHBI) or lower hemibody irradiation (LHBI). Less common is mid-body irradiation (MBI). In the treatment of both halves of the body sequentially, hemibody irradiation permits radiotherapy of the whole body with larger doses of radiation than could be accomplished with WHOLE-BODY IRRADIATION. It is sometimes called "systemic" hemibody irradiation with reference to its use in widespread cancer or metastases. (P. Rubin et al. Cancer, Vol 55, p2210, 1985)

A heterogeneous group of sporadic or familial disorders characterized by AMYLOID deposits in the walls of small and medium sized blood vessels of CEREBRAL CORTEX and MENINGES. Clinical features include multiple, small lobar CEREBRAL HEMORRHAGE; cerebral ischemia (BRAIN ISCHEMIA); and CEREBRAL INFARCTION. Cerebral amyloid angiopathy is unrelated to generalized AMYLOIDOSIS. Amyloidogenic peptides in this condition are nearly always the same ones found in ALZHEIMER DISEASE. (from Kumar: Robbins and Cotran: Pathologic Basis of Disease, 7th ed., 2005)

Pathological conditions of intracranial ARTERIES supplying the CEREBRUM. These diseases often are due to abnormalities or pathological processes in the ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; and POSTERIOR CEREBRAL ARTERY.

More From BioPortfolio on "Evaluation of Resection Quality of Cerebral Metastases Using Fluorescence Guided Surgery: a Prospective Randomised Study"

Quick Search

Relevant Topics

Nutrition
Within medicine, nutrition (the study of food and the effect of its components on the body) has many different roles. Appropriate nutrition can help prevent certain diseases, or treat others. In critically ill patients, artificial feeding by tubes need t...

Public Health
Alternative Medicine Cleft Palate Complementary & Alternative Medicine Congenital Diseases Dentistry Ear Nose & Throat Food Safety Geriatrics Healthcare Hearing Medical Devices MRSA Muscular Dyst...

Cancer
  Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...


Searches Linking to this Trial