脑转移瘤（BMs）的最大切除术可改善无进展生存期和总生存期（OS）。荧光素钠（FL）结合黄色560纳米滤光片在BMs切除期间用于可视化残留肿瘤组织是一种安全可行的方法。本研究的作者旨在证明使用FL将积极影响切除术的体积范围（EOR），从而对接受BMs切除的患者的生存结果产生影响。通过分析他们机构的前瞻性脑肿瘤登记簿，作者使用术前高质量MR图像进行体积分析，识别出539例连续患有BMs的患者（247名女性，平均年龄62.8岁）。在293名患者（54.4％，WL组）中，在白光下切除BMs，在246名患者（45.6％，FL组）中，在FL引导下切除BMs。两组之间的性别，年龄，术前Karnofsky生活质量评分（KPS），递归分区分析类别和辅助治疗形式均平衡。通过在盲视状态下量化增强顺磁性蛋白-1加权序列的术前和术后肿瘤体积，进行了体积分析。在FL组中，术后肿瘤体积显著较小（p = 0.01），因此定量EOR显著较大（p = 0.024），OS显著较长（p = 0.0001）（对数秩检验）。多变量Cox回归模型表明，年龄，术前KPS，转移状态和FL引导下的切除是独立的预后因子。与WL切除相比，FL引导的BMs切除提高了切除质量，显著改善了EOR，并延长了OS。

Maximal resection of brain metastases (BMs) improves both progression-free survival and overall survival (OS). Fluorescein sodium (FL) in combination with the YELLOW 560-nm filter is a safe and feasible method for visualizing residual tumor tissue during BM resection. The authors of this study aimed to show that use of FL would positively influence the volumetric extent of resection (EOR) and thus the survival outcome in patients undergoing BM resection.Analyzing their institution's prospective brain tumor registry, the authors identified 539 consecutive patients with BMs (247 women, mean age 62.8 years) by using preoperative high-quality MR images for volumetric analysis. BMs were resected under white light (WL) in 293 patients (54.4%; WL group) and under FL guidance in 246 patients (45.6%; FL group). Sex, age, presurgical Karnofsky Performance Status (KPS), recursive partitioning analysis class, and adjuvant treatment modalities were well balanced between the two groups. Volumetric analysis was performed in a blinded fashion by quantifying pre- and postoperative tumor volume based on gadolinium-enhanced T1-weighted sequences.In the FL group, the postoperative tumor volume was significantly smaller (p = 0.01), and hence the quantitative EOR was significantly larger (p = 0.024) and OS was significantly longer (p = 0.0001) (log-rank testing). Multivariate Cox regression modeling showed that age, presurgical KPS, metastasis status, and FL-guided resection are independent prognostic factors for survival.Compared with WL resection, FL-guided BM resection increased resection quality, significantly improved EOR, and prolonged OS.