{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T12:25:34Z","timestamp":1776947134176,"version":"3.51.4"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T00:00:00Z","timestamp":1716595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T00:00:00Z","timestamp":1716595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172834"],"award-info":[{"award-number":["82172834"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Key Technology Research and Development Program of the Ministry of Science and Technology of China","award":["2022YFE0133400"],"award-info":[{"award-number":["2022YFE0133400"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Res Clin Oncol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The vital function of eloquent and deep brain areas necessitates precise treatment for tumors located in these regions. Fluorescein-guided surgery (FGS) has been widely used for high-grade gliomas (HGGs) resection. Nevertheless, the safety and efficacy of utilizing this technique for resecting brain tumors located in eloquent and deep-seated areas remain uncertain. This study aims to assess the safety and extent of resection of HGGs in these challenging tumors with fluorescein and explore its impact on patient survival.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective analysis was conducted on the clinical and radiological data of 67 consecutive patients with eloquent or deep-seated HGGs who underwent surgery between January 2020 and June 2023. Lacroix functional location grade was used to determine the eloquence of the tumors. The comparison between the fluorescence-guided surgery group (FGS, <jats:italic>n<\/jats:italic>\u2009=\u200932) and the conventional white-light microscopic surgery group (non-FGS, <jats:italic>n<\/jats:italic>\u2009=\u200935) included assessments of extent of resection (EOR), rates of gross total resection (GTR, 100%) and near-total resection (NTR, 99 to 98%), postoperative Neurologic Assessment in Neuro-Oncology (NANO) scores, overall survival (OS), and progression-free survival (PFS), to evaluate the safety and efficacy of fluorescein-guided technology in tumor resection at these specific locations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Baseline of demographics, lesion location, and pathology showed no significant difference between the two groups. GTR of the FGS group was higher than the non-FGS group (84.4% vs. 60.0%, OR 3.60, 95% CI 1.18\u201310.28, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The FGS group also showed higher GTR\u2009+\u2009NTR (EOR\u2009\u2265\u200998%) than the non-FGS group (93.8% vs. 65.7%, OR 7.83, 95% CI 1.86\u201336.85, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). 87.0% of eloquent tumors (Lacroix grade III) in the FGS group achieved GTR\u2009+\u2009NTR, compared to 52.2% of control group (OR 6.11, 95% CI 1.50\u201322.78, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). For deep-seated tumors, the rate of GTR\u2009+\u2009NTR in the two groups were 91.7% and 53.3%, respectively (OR 9.62, 95% CI 1.05\u2013116.50, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). No significant difference of the preoperative NANO score of the two groups was found. The postoperative NANO score of the FGS group was significantly lower than the non-FGS group (2.56\u2009\u00b1\u20091.29 vs. 3.43\u2009\u00b1\u20091.63, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Median OS of the FGS group was 4.2 months longer than the non-FGS group despite no statistical difference (18.2 months vs. 14.0 months, HR 0.63, 95% CI 0.36\u20131.11, <jats:italic>p<\/jats:italic>\u2009=\u20090.112), while PSF was found significantly longer in FGS patients than those of the non-FGS group (11.2 months vs. 7.7 months, HR 0.59, 95% CI 0.35\u20130.99, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Sodium fluorescein-guided surgery for high-grade gliomas in eloquent and deep-seated brain regions enables more extensive resection while preserving neurologic function and improve patient survival.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00432-024-05796-1","type":"journal-article","created":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T11:01:32Z","timestamp":1716634892000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fluorescein-guided surgery in high-grade gliomas: focusing on the eloquent and deep-seated areas"],"prefix":"10.1007","volume":"150","author":[{"given":"Yao","family":"Xiao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingrui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaoying","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,25]]},"reference":[{"key":"5796_CR1","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1007\/s00701-013-1734-9","volume":"155","author":"F Acerbi","year":"2013","unstructured":"Acerbi F, Broggi M, Eoli M et al (2013) Fluorescein-guided surgery for grade IV gliomas with a dedicated filter on the surgical microscope: preliminary results in 12 cases. 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