A meta-analysis of the value of indocyanine green fluorescence imaging in guiding surgical resection of primary and metastatic liver cancer

IF 3.1 3区医学 Q2 ONCOLOGY Photodiagnosis and Photodynamic Therapy Pub Date : 2025-01-18 DOI:10.1016/j.pdpdt.2025.104489

Dali Xiong , Jiaran Li , Li Li , Fuhao Xu , Tao Hu , He Zhu , Xiaohui Xu , Yawen Sun , Shuanghu Yuan

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Abstract

Objective

This meta-analysis aimed to evaluate the value of indocyanine green fluorescence imaging in precision resection surgery for primary and metastatic liver cancer.

Methods

A systematic search of PubMed, Embase, Scopus, Cochrane Library, Web of Science, ScienceDirect, and major scientific websites was conducted until June 2024. Randomized controlled trials and observational studies comparing indocyanine green fluorescence imaging-guided liver cancer resection with traditional methods were included. The meta-analysis incorporated overall outcomes and subgroup outcomes based on liver cancer types (primary and metastatic). StataSE 12.0 software was used for statistical analysis after a quality assessment of the included studies.

Results

Twenty studies involving 1,283 patients with liver cancer were included. The results showed that indocyanine green fluorescence imaging significantly reduced intraoperative blood loss [Weighted mean difference (WMD), –88.75; 95 % CI, –128.48 to –49.02, p < 0.05], transfusion rate [Odds ratios (OR), 0.5; 95 % CI, 0.36–0.7, p < 0.05], hospital stay duration [WMD, –1.11; 95 % CI, –1.79 to –0.43, p < 0.05], and the overall complication rate [OR, 0.59; 95 % CI, 0.44–0.79, p < 0.05]. However, no significant differences were observed in operative time or in the subgroup analysis for metastatic liver cancer.

Conclusion

Indocyanine green fluorescence imaging is a safe and effective intraoperative navigation technique that improves surgical outcomes and prognostic indicators in liver cancer resection. However, its efficacy in metastatic liver cancer surgery requires further validation through larger-scale, rigorous, prospective, randomized controlled trials.

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吲哚菁绿荧光成像指导原发性和转移性肝癌手术切除价值的荟萃分析。

目的：本荟萃分析旨在评价吲哚菁绿荧光成像在原发性和转移性肝癌精确切除手术中的价值。方法：系统检索PubMed、Embase、Scopus、Cochrane Library、Web of Science、ScienceDirect等主要科学网站，检索截止至2024年6月。随机对照试验和观察性研究比较吲哚菁绿荧光成像引导肝癌切除与传统方法。荟萃分析纳入了基于肝癌类型（原发性和转移性）的总体结果和亚组结果。对纳入的研究进行质量评价后，使用StataSE 12.0软件进行统计分析。结果：纳入了20项研究，涉及1283例肝癌患者。结果显示吲哚菁绿荧光显像可显著降低术中出血量[加权平均差（WMD）， -88.75；95% CI, -128.48 ~ -49.02，结论：吲哚菁绿荧光成像是一种安全有效的术中导航技术，可改善肝癌切除术的手术效果和预后指标。然而，其在转移性肝癌手术中的疗效需要通过更大规模、严格、前瞻性、随机对照试验进一步验证。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.