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A systematic methodology review of fluorescence-guided cancer surgery to inform the development of a core master protocol and outcome set

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2024年6月7日

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  • Abigail E. Vallance,
  • Daniel Elson,
  • Stefano Giuliani,
  • Kenneth Rankin,
  • Graeme Stasiuk,
  • Myles Smith,
  • Daniel Leff,
  • Vinidh Paleri,
  • Angus McNair,
  • Erum Ahmad,
  • Hashim Ahmed,
  • Antony Antypas,
  • Amir Anuar,
  • Alice Appleton,
  • Cara Beattie,
  • Disha Bhadbury,
  • Rhiannon Brignall,
  • Claudia Burton,
  • Ollie Burton,
  • Janice Chow,
  • Howard Chu,
  • Kelly Chu,
  • Brian Cunningham,
  • Elizabeth Daly,
  • Noor Dhakal,
  • Michael Douek,
  • Ben Doughty,
  • Kaylem Feeney,
  • Alex Fleet,
  • Hayley Fowler,
  • Michael Fu,
  • Mark Galea,
  • Hannah Glatzel,
  • Esther Goh,
  • Hannah Grimes,
  • Mei-Yin Gruber,
  • Natalia Hackett,
  • Mark Hanson,
  • Jessica Helm,
  • George Higginbottham,
  • Rayyan Islam,
  • Alisha Jaffer,
  • Marwa Jama,
  • Rama Jha,
  • Jade Kabbani,
  • Jamil Kabbani,
  • Ayesha Kahn,
  • Jessica Kennett,
  • Ariella Levene,
  • Ethan Losty,
  • Andie Lun,
  • Krzysztof Macierzanka,
  • Fahad Mahmood,
  • Jed Maliyil,
  • Emily-Jane Mitchell,
  • Intisar Mohamed,
  • Ali Mohammed,
  • Marco Mund,
  • James Odedra,
  • Olufemi Olatigbe,
  • Maeve O’Neill,
  • Daniel-Clement Osei-Bordom,
  • Ariadni Papadopoulou,
  • Manal Patel,
  • Arnie Purushotham,
  • Fang Fang Quek,
  • Euan Ramsay,
  • Luke James Roberts,
  • Augustus Rottenberg,
  • Elizabeth Ryan Harper,
  • Lucy Scales,
  • Preeyan Shah,
  • Chloe Short,
  • Keng Siang Lee,
  • Eleanor Smyth,
  • Ollie Squires,
  • Aiswarya Sukumar,
  • Harsha Thangavijayan,
  • Arun Thirunavukarasu,
  • Dalia Thomas,
  • Carrie Thorpe,
  • Alexandra Uren,
  • Jayant Vaidya,
  • Florence Wallace,
  • Nora Wangari Murage,
  • Mary Xie Lee,
  • Clayton Yang Hashim Ahmed,
  • Kelly Avery,
  • Jane Blazeby,
  • Natalie Blencowe,
  • Richard Bryant,
  • David Chang,
  • Sian Cousins,
  • Michael Douek,
  • Christin Hoffman,
  • David Jayne,
  • Connor Jones,
  • Rhiannon Macefield,
  • Barry Main,
  • Samir Pathak,
  • Shelley Potter,
  • Arnie Purushotham,
  • Grant Stewart,
  • Danail Stoyanov,
  • Jayant Vaidya,
  • Tom Vercauteren,
  • Dale Vimalachandran,
  • Oliver Brewster,
  • Manuk Wijeyaratne

摘要

Background

Fluorescence-guided precision cancer surgery may improve survival and minimize patient morbidity. Efficient development of promising interventions is however hindered by a lack of common methodology. This methodology review aimed to synthesize descriptions of technique, governance processes, surgical learning and outcome reporting in studies of fluorescence-guided cancer surgery to provide guidance for the harmonized design of future studies.

Methods

A systematic search of MEDLINE, EMBASE and CENTRAL databases from 2016–2020 identified studies of all designs describing the use of fluorescence in cancer surgery. Dual screening and data extraction was conducted by two independent teams.

Results

Of 13,108 screened articles, 426 full text articles were included. The number of publications per year increased from 66 in 2016 to 115 in 2020. Indocyanine green was the most commonly used fluorescence agent (391, 91.8%). The most common reported purpose of fluorescence guided surgery was for lymph node mapping (195, 5%) and non-specific tumour visualization (94, 2%). Reporting about surgical learning and governance processes incomplete. A total of 2,577 verbatim outcomes were identified, with the commonly reported outcome lymph node detection (796, 30%). Measures of recurrence (32, 1.2%), change in operative plan (23, 0.9%), health economics (2, 0.1%), learning curve (2, 0.1%) and quality of life (2, 0.1%) were rarely reported.

Conclusion

There was evidence of methodological heterogeneity that may hinder efficient evaluation of fluorescence surgery. Harmonization of the design of future studies may streamline innovation.