Perspective Chapter: The Use of Fluorescence in Ovarian Cancer Surgery

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In this modern era, one might find several innovative treatments that are constantly updating themselves and are thus shaping the future of therapy in ovarian cancer patients. The major challenge confronting the clinician is selecting from a range of established and traditional treatment methods (such as chemotherapy or immunotherapy) versus new nanotechnology advancements and gene therapy, which have newly emerged but are evolving rapidly. In terms of surgery, modern-day updates can offer a more precise and up-to-date treatment, with various options to adapt the technique to the patient’s particular needs and indications. An excellent example of surgical modern-day enhancement is fluorescence. Given that complete cytoreduction is a vital prognostic element in advanced epithelial ovarian cancer, surgery enhanced by fluorescence using fluorescent markers might significantly improve the identification of microscopic disease and the prognosis of surgical treatment. Additionally, CD24, a receptor on the cell surface, presents overexpression in 70% of solid tumors and could serve as a predictive and therapeutic biomarker for epithelial ovarian cancer. Recent preclinical studies have demonstrated that CD24-targeted imaging agents enhance tumor removal and noninvasive fluorescence visualization in orthotopic patient-derived xenograft models of epithelial ovarian cancer. Additionally, fluorescence-guided cytoreductive surgery targeting human epidermal growth factor receptor two or folate receptor alpha has demonstrated feasibility in both animal models and individuals with epithelial ovarian cancer. In conclusion, fluorescence-guided surgery may enhance the diagnosis of ovarian cancer micrometastasis and sentinel lymph nodes. More precise future research is required to determine whether the use of this method improves patient outcomes.

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