Abstract
Colorectal cancer (CRC) is a common cause of cancer and cancer-related death. Surgery is the only curative modality. Fluorescence-enhanced visualization of CRC with targeted fluorescent probes that can delineate boundaries and target tumor-specific biomarkers can increase rates of curative resection. Approaches to enhancing visualization of the tumor-to-normal tissue interface are active areas of investigation. Nonspecific dyes are the most-used approach, but tumor-specific targeting agents are progressing in clinical trials. The present narrative review describes the principles of fluorescence targeting of CRC for diagnosis and fluorescence-guided surgery with molecular biomarkers for preclinical or clinical evaluation.
Highlights
Colorectal cancer (CRC) is a common cause of cancer and cancer-related death
Barabino et al used a similar dose in patients with peritoneal carcinomatosis 24 h prior to surgery and found lower sensitivity and specificity of 72.4% and 60.0%, respectively which suggests that 24 h after a lower dose of indocyanine green (ICG) may be insufficient for optimal fluorescence enhancement
Preclinical evaluation of Mucin 1 (Muc1) and other mucins for Fluorescence-guided surgery (FGS) in CRC is currently ongoing, and the results will be promising for clinical translation
Summary
Colorectal cancer (CRC) is a common cause of cancer and cancer-related death. Surgery is the only curative modality. Complete resection with negative margins is the primary aim of oncologic surgery For colon cancer, this involves removal of the colon segment containing the tumor, its affected vascular pedicle, and the lymphatic drainage basin of the affected segment [3]. Further assessments via intraoperative pathologic frozen sections are time-consuming and can be affected by sampling error, as there is a large surface area to sample from This can be further exacerbated by the trend towards minimally invasive resections for colorectal cancer and the trend towards total neoadjuvant therapy. Once the surgery is underway, fluorescence imaging can be utilized periodically to better define the location of the tumor in relation to surrounding tissue and anatomic structures This can be performed in a minimally invasive fashion with fluorescence-capable laparoscopes or in a traditional open laparotomy with hand-held devices. Fluorescence can improve the detection rate of CRC from adenomas and provide further information to care for patients in whom a watch-and-wait approach is being used after neoadjuvant treatment
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