Fluorescence-guided surgery in colorectal cancer; A review on clinical results and future perspectives

Hidde A. Galema; Ruben P.J. Meijer; Lorraine J. Lauwerends; Cornelis Verhoef; Jacobus Burggraaf; Alexander L. Vahrmeijer; Merlijn Hutteman; Stijn Keereweer; Denise E. Hilling

doi:10.1016/j.ejso.2021.10.005

Fluorescence-guided surgery in colorectal cancer; A review on clinical results and future perspectives

Hidde A. Galema, Ruben P.J. Meijer, Lorraine J. Lauwerends, Cornelis Verhoef, Jacobus Burggraaf, Alexander L. Vahrmeijer, Merlijn Hutteman, Stijn Keereweer, Denise E. Hilling^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › Academic › peer-review

12 Citations (Scopus)

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Abstract

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.

Original language	English
Pages (from-to)	810-821
Number of pages	12
Journal	European Journal of Surgical Oncology
Volume	48
Issue number	4
Early online date	9 Oct 2021
DOIs	https://doi.org/10.1016/j.ejso.2021.10.005
Publication status	Published - Apr 2022

Bibliographical note

Funding Information:
Funding for this study was obtained by the Bas Mulder Award granted to DEH by the Alpe d’HuZes Foundation and Dutch Cancer Society (grant UL2015-7966 ), and by the Dutch Cancer Society (grants UL2015-8089 and UL2017-11363 ).

Funding Information:
Funding for this study was obtained by the Bas Mulder Award granted to DEH by the Alpe d'HuZes Foundation and Dutch Cancer Society (grant UL2015-7966), and by the Dutch Cancer Society (grants UL2015-8089 and UL2017-11363).

Publisher Copyright:
© 2021 The Authors

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1-s2.0-S0748798321007551-mainFinal published version, 1.65 MBLicence: CC BY

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@article{1599b7f472b746dea8cfd33b23da3f43,

title = "Fluorescence-guided surgery in colorectal cancer; A review on clinical results and future perspectives",

abstract = "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 {\textquoteleft}fluorescence-guided surgery{\textquoteright}, {\textquoteleft}colorectal surgery{\textquoteright}, and {\textquoteleft}colorectal cancer{\textquoteright} 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.",

author = "Galema, {Hidde A.} and Meijer, {Ruben P.J.} and Lauwerends, {Lorraine J.} and Cornelis Verhoef and Jacobus Burggraaf and Vahrmeijer, {Alexander L.} and Merlijn Hutteman and Stijn Keereweer and Hilling, {Denise E.}",

note = "Funding Information: Funding for this study was obtained by the Bas Mulder Award granted to DEH by the Alpe d{\textquoteright}HuZes Foundation and Dutch Cancer Society (grant UL2015-7966 ), and by the Dutch Cancer Society (grants UL2015-8089 and UL2017-11363 ). Funding Information: Funding for this study was obtained by the Bas Mulder Award granted to DEH by the Alpe d'HuZes Foundation and Dutch Cancer Society (grant UL2015-7966), and by the Dutch Cancer Society (grants UL2015-8089 and UL2017-11363). Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2022",

month = apr,

doi = "10.1016/j.ejso.2021.10.005",

language = "English",

volume = "48",

pages = "810--821",

journal = "European Journal of Surgical Oncology",

issn = "0748-7983",

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T1 - Fluorescence-guided surgery in colorectal cancer; A review on clinical results and future perspectives

AU - Galema, Hidde A.

AU - Meijer, Ruben P.J.

AU - Lauwerends, Lorraine J.

AU - Verhoef, Cornelis

AU - Burggraaf, Jacobus

AU - Vahrmeijer, Alexander L.

AU - Hutteman, Merlijn

AU - Keereweer, Stijn

AU - Hilling, Denise E.

N1 - Funding Information: Funding for this study was obtained by the Bas Mulder Award granted to DEH by the Alpe d’HuZes Foundation and Dutch Cancer Society (grant UL2015-7966 ), and by the Dutch Cancer Society (grants UL2015-8089 and UL2017-11363 ). Funding Information: Funding for this study was obtained by the Bas Mulder Award granted to DEH by the Alpe d'HuZes Foundation and Dutch Cancer Society (grant UL2015-7966), and by the Dutch Cancer Society (grants UL2015-8089 and UL2017-11363). Publisher Copyright: © 2021 The Authors

PY - 2022/4

Y1 - 2022/4

N2 - 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.

AB - 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.

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SN - 0748-7983

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JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

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ER -

Fluorescence-guided surgery in colorectal cancer; A review on clinical results and future perspectives

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