Fluorescence-guided surgery in colorectal cancer; A review on clinical results and future perspectives.
Colorectal cancer
Fluorescence-guided surgery
Of vital structures
Sentinel lymph node imaging
Tumour imaging
imaging of perfusion
Journal
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
24
08
2021
accepted:
07
10
2021
pubmed:
19
10
2021
medline:
13
4
2022
entrez:
18
10
2021
Statut:
ppublish
Résumé
Colorectal cancer is the fourth most diagnosed malignancy worldwide and surgery is one of the cornerstones of the treatment strategy. Near-infrared (NIR) fluorescence imaging is a new and upcoming technique, which uses an NIR fluorescent agent combined with a specialised camera that can detect light in the NIR range. It aims for more precise surgery with improved oncological outcomes and a reduction in complications by improving discrimination between different structures. A systematic search was conducted in the Embase, Medline and Cochrane databases with search terms corresponding to 'fluorescence-guided surgery', 'colorectal surgery', and 'colorectal cancer' to identify all relevant trials. The following clinical applications of fluorescence guided surgery for colorectal cancer were identified and discussed: (1) tumour imaging, (2) sentinel lymph node imaging, (3) imaging of distant metastases, (4) imaging of vital structures, (5) imaging of perfusion. Both experimental and FDA/EMA approved fluorescent agents are debated. Furthermore, promising future modalities are discussed. Fluorescence-guided surgery for colorectal cancer is a rapidly evolving field. The first studies show additional value of this technique regarding change in surgical management. Future trials should focus on patient related outcomes such as complication rates, disease free survival, and overall survival.
Sections du résumé
BACKGROUND
Colorectal cancer is the fourth most diagnosed malignancy worldwide and surgery is one of the cornerstones of the treatment strategy. Near-infrared (NIR) fluorescence imaging is a new and upcoming technique, which uses an NIR fluorescent agent combined with a specialised camera that can detect light in the NIR range. It aims for more precise surgery with improved oncological outcomes and a reduction in complications by improving discrimination between different structures.
METHODS
A systematic search was conducted in the Embase, Medline and Cochrane databases with search terms corresponding to 'fluorescence-guided surgery', 'colorectal surgery', and 'colorectal cancer' to identify all relevant trials.
RESULTS
The following clinical applications of fluorescence guided surgery for colorectal cancer were identified and discussed: (1) tumour imaging, (2) sentinel lymph node imaging, (3) imaging of distant metastases, (4) imaging of vital structures, (5) imaging of perfusion. Both experimental and FDA/EMA approved fluorescent agents are debated. Furthermore, promising future modalities are discussed.
CONCLUSION
Fluorescence-guided surgery for colorectal cancer is a rapidly evolving field. The first studies show additional value of this technique regarding change in surgical management. Future trials should focus on patient related outcomes such as complication rates, disease free survival, and overall survival.
Identifiants
pubmed: 34657780
pii: S0748-7983(21)00755-1
doi: 10.1016/j.ejso.2021.10.005
pii:
doi:
Substances chimiques
Fluorescent Dyes
0
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
810-821Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Alexander L Vahrmeijer and Cornelis Verhoef are local principal investigators of several industry driven studies initiated by Surgimab (Montpellier, France) using SGM-101 without any personal financial interests. Surgimab was not involved in the process of creating this manuscript. The other authors declare no competing interests. Study concepts: S.K., D.H. Study design: H.G., R.M., S.K., D.H. Data acquisition: H.G., R.M. Quality control of data and algorithms: H.G., R.M. Data analysis and interpretation: na Statistical analysis: na Manuscript preparation: H.G., R.M., S.K., D.H. Manuscript editing: H.G., R.M., S.K., D.H. Manuscript review: L.L., C.V., J.B., A.V., M.H.