To what extent will 5-aminolevulinic acid change the face of malignant glioma surgery?
Díez Valle R(1), Tejada Solis S(1).
(1) Department of Neurosurgery, Clínica Universidad de Navarra, Navarre, Spain.
Glioma surgery is an essential part of glioma management; however, fully achieving the goal of surgery has been uncommon. The goal of surgery is 'maximal safe resection' with the accepted target for maximal being complete resection of the contrast-enhancing tumor.
This ideal result was obtained in less than 30% of cases in centers of excellence until a few years ago. The development of fluorescence-guided surgery using 5-aminolevulinic acid has initiated a radical change. Over the past 5 years, various groups have published rates of complete resection of the enhancing tumor that exceed 80%. In the coming years, as the use of the technology expands, complete resection should become a common, predictable result at many centers.
Consequently, adjuvant therapies that benefit from resection could play a bigger role, resection could be incorporated as a variable in randomized trials and distant recurrence might become a more common problem.
CITATION CNS Oncol. 2015 Jun 29:1-8.