| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | European Urology | ||||
| Publisher: | ELSEVIER SCIENCE BV | ||||
| Place of Publication: | AMSTERDAM | ||||
| Volume: | 55 | ||||
| Number of Issue or Book Chapter: | 6 | ||||
| Page Range: | pp. 1281-1288 | ||||
| Date: | 2009 | ||||
| Institutions: | Medicine > Lehrstuhl für Pathologie Medicine > Lehrstuhl für Urologie | ||||
| Identification Number: |
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| Keywords: | PROTOPORPHYRIN-IX FLUORESCENCE; INDUCED PORPHYRIN FLUORESCENCE; BEAM RADIATION-THERAPY; EARLY BLADDER-CANCER; CONSECUTIVE PATIENTS; GUIDED RESECTION; LESIONS; GLIOMA; 5-aminolevulinic acid; 5-ALAFluorescence; PDD; Photodynamic diagnosis; Prostate cancer; Protoporphyrin IX; Radical prostatectomy; Surgical margin | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 67119 |
Web of ScienceAbstract
Background: Surgical margin status after radical prostatectomy (RP) is a significant risk factor for tumour recurrence. it is an intriguing concept to find a fluorescence marker for photodynamic diagnosis (PDD) to make tumour margins visible during surgery. Objective: To investigate the feasibility of identification of positive surgical margins (PSM) during open retropubic or endoscopic ...
Abstract
Background: Surgical margin status after radical prostatectomy (RP) is a significant risk factor for tumour recurrence. it is an intriguing concept to find a fluorescence marker for photodynamic diagnosis (PDD) to make tumour margins visible during surgery. Objective: To investigate the feasibility of identification of positive surgical margins (PSM) during open retropubic or endoscopic extraperitoneal RP by 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX) to enhance surgical radicality. Design, setting, and participants: Thirty-nine patients (Gleason score 6-10, prostate-specific antigen [PSA] 2.3-120 ng/ml) received 20 mg/kg of body weight of 5-ALA orally and underwent RP (24 endoscopic extraperitoneal, 15 open retropubic). Measurements: A PDD-suitable laparoscopy optic (Karl-Storz GmbH, Tuttlingen, Germany) with a yellow long-pass filter was coupled to a fibre-optic light cord with an excitation light source (380-420 nm, D-Light, Karl-Storz GmbH, Tuttlingen, Germany) for fluorescence excitation of PpIX and to a PDD-suitable camera for video and photo documentation by the AIDA DVD system (Karl-Storz GmbH, Tuttlingen, Germany). Results and limitations: There were more false-negative cases in the open group (four vs two) than in the endoscopic group but more false-positive cases in the endoscopic group (two vs none) than in the open group. The overall sensitivity and specificity were 56% and 91.6%, respectively. The sensitivity of the endoscopic cases was much higher (75% vs 38%) than for the open cases, while the specificity was higher for the open group (88.2% vs 100%). Conclusions: PDD with 5-ALA-induced PpIX during RP might be a feasible and effective method for reducing the rate of PSM. The technique seems to be more practicable during endoscopic RP rather than open RP. Further clinical studies with higher patient volumes and further development of the technique seem justified. Trial registration: EudraCT: 2005-004406-93. (C) 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Metadata last modified: 19 Dec 2024 12:06
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