PDF(Pubmed)
Abstract：
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.
CONCLUSIONS: There was evidence of methodological heterogeneity that may hinder efficient evaluation of fluorescence surgery. Harmonization of the design of future studies may streamline innovation.
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.
CONCLUSIONS: There was evidence of methodological heterogeneity that may hinder efficient evaluation of fluorescence surgery. Harmonization of the design of future studies may streamline innovation.
摘要：
背景：荧光引导的精准癌症手术可以提高生存率并降低患者发病率。然而，缺乏共同的方法阻碍了有希望的干预措施的有效发展。这篇方法论综述旨在综合技术描述，治理过程，荧光引导癌症手术研究中的外科学习和结果报告，为未来研究的协调设计提供指导。
方法：对MEDLINE的系统搜索，2016-2020年的EMBASE和CENTRAL数据库确定了描述荧光在癌症手术中使用的所有设计的研究。由两个独立的团队进行双重筛选和数据提取。
结果：在13,108篇筛选的文章中，共纳入426篇全文。每年的出版物数量从2016年的66个增加到2020年的115个。吲哚菁绿是最常用的荧光剂(391,91.8%)。据报道，荧光引导手术的最常见目的是淋巴结定位（195，5％）和非特异性肿瘤可视化（94，2％）。关于外科学习和治理过程的报告不完整。总共确定了2,577个逐字结果，与通常报告的结果淋巴结检测（796，30％）。复发措施（32，1.2%），手术计划的变化（23，0.9%），卫生经济学（2，0.1%），很少报道学习曲线(2,0.1%)和生活质量(2,0.1%).
结论：有证据表明方法学上的异质性可能会阻碍荧光手术的有效评估。未来研究设计的协调可能会简化创新。
方法：对MEDLINE的系统搜索，2016-2020年的EMBASE和CENTRAL数据库确定了描述荧光在癌症手术中使用的所有设计的研究。由两个独立的团队进行双重筛选和数据提取。
结果：在13,108篇筛选的文章中，共纳入426篇全文。每年的出版物数量从2016年的66个增加到2020年的115个。吲哚菁绿是最常用的荧光剂(391,91.8%)。据报道，荧光引导手术的最常见目的是淋巴结定位（195，5％）和非特异性肿瘤可视化（94，2％）。关于外科学习和治理过程的报告不完整。总共确定了2,577个逐字结果，与通常报告的结果淋巴结检测（796，30％）。复发措施（32，1.2%），手术计划的变化（23，0.9%），卫生经济学（2，0.1%），很少报道学习曲线(2,0.1%)和生活质量(2,0.1%).
结论：有证据表明方法学上的异质性可能会阻碍荧光手术的有效评估。未来研究设计的协调可能会简化创新。
