The following is a summary of “A Systematic Methodology Review of Fluorescence-guided Cancer Surgery to Inform the Development of a core master protocol and Outcome set,” published in the June 2024 issue of Oncology by Vallance et al.

Fluorescence-guided precision surgery holds promise for enhancing patient outcomes in cancer treatment by improving survival rates and reducing morbidity. However, the advancement of these techniques is impeded by a need for standardized methodologies across studies. This systematic methodology review aimed to synthesize and analyze current literature on fluorescence-guided cancer surgery, focusing on procedural techniques, governance processes, surgical learning curves, and outcome reporting to inform the development of unified protocols for future research.

The systematic search of MEDLINE, EMBASE, and CENTRAL databases identified 426 full-text articles out of 13,108 screened studies published between 2016 and 2020. The annual publication rate steadily increased, reflecting growing interest and advancements in the field. Indocyanine green emerged as the predominant fluorescence agent utilized in 91.8% of cases, predominantly for lymph node mapping (195, 5%) and non-specific tumor visualization (94, 2%). However, the review highlighted incomplete reporting on surgical learning processes and governance frameworks, posing challenges to comprehensive evaluation and comparison across studies.

Researchers identified 2,577 unique outcome measures, with lymph node detection (796, 30%) being the most frequently reported. Notably, outcomes such as recurrence rates, changes in operative plans (23, 0.9%), health economics (2, 0.1%), learning curve assessments (2, 0.1%), and quality of life (2, 0.1%) impacts were markedly underreported, underscoring the need for standardized outcome sets in future research endeavors.

In conclusion, the observed methodological heterogeneity underscores the necessity for harmonizing study designs and outcome-reporting frameworks in fluorescence-guided cancer surgery. Such harmonization efforts are essential to facilitate rigorous evaluation of these innovative surgical techniques and ultimately enhance their clinical utility and impact on patient care. Future research should prioritize the development of core protocols and outcome sets to promote consistency and comparability across studies, thereby advancing the field toward improved treatment standards and patient outcomes.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12386-4