image: This figure depicts overall survival and local in-brain recurrence-free survival in the study's subgroups.
The cover for issue 32 of Oncotarget features Figure 2, "This figure depicts overall survival and local in-brain recurrence-free survival in the study's subgroups," by Hussein, et al. which reported that the aim of the present study is to assess whether the use of 5-ALA has an impact on local recurrence or survival compared to conventional white light microscopic tumor resection.
Two groups were compared:
In the “white light” group, resection was performed with conventional microscopy.
In the 5-ALA group, fluorescence guided peritumoral resection was additionally performed after standard microscopic resection.
Local in-brain recurrence occurred in 21/175 patients with a rate of 15/119 in the white light and 6/56 in the 5-ALA group.
The use of 5-ALA did not result in lower in-brain recurrence or mortality compared to the use of white light microscopy.
Dr. Bawarjan Schatlo from the Department of Neurosurgery at The University of Medicine Goettingen said, "Metastatic brain disease is more common than primary brain tumors."
"Metastatic brain disease is more common than primary brain tumors."
Another group made the case for extending tumor resection 5 millimeters into peritumoral tissue to perform a so-called supramarginal resection.
Its aim is to prolong progression-free survival through radical resection and improved local tumor control.
In a series of 52 patients, Kamp and colleagues detected positive fluorescence in 62% of resected cerebral metastases.
Thus, the utility and importance of using methods to improve local control of brain metastases remains an unresolved issue.
The aim of the current study was to compare survival and local recurrence in a cohort of patients who underwent surgery for brain metastases with 5-ALA fluorescence microscopy to one that was operated using microscopic white light only.
The Schatlo Research Team concluded in their Oncotarget Research Paper, "the present study confirmed that regardless of surgical adjunct, radiotherapy is strongly associated with improved survival."