Efficacy Of Fluorescence-Guided Surgery On Primary Human Osteosarcoma

Abstract We investigated the effectiveness of fluorescence-guided surgery (FGS) to improve outcomes in an orthotopic mouse model of human osteosarcoma. 143B-RFP human osteosarcoma cells were injected into the intramedullary cavity of the tibia in 32 nude mice. Two weeks after the implantation, 16 mice underwent FGS, and the other 16 mice underwent bright-light surgery (BLS). Half of the BLS and FGS mice (8 mice in each group) underwent adjuvant chemotherapy with cisplatin. Weekly imaging of the mice was performed and RFP-expressing areas were recorded. The fluorescent area of residual tumor after BLS and FGS were 10.2 ± 2.4 mm2 and 0.1 ± 0.1 mm2, respectively (P < 0.001). The residual tumor grew after BLS and BLS+CDDP. In contrast, the FGS mice and the FGS+CDDP mice had almost no tumor growth. Disease-free survival (DFS) in the BLS-, the BLS+CDDP-, the FGS-, and the FGS+CDDP-treated mice was 12.5%, 37.5%, 75.0%, and 87.5%, respectively. The FGS-treated mice had significantly higher DFS rate than the BLS-treated mice (P = 0.021), and the FGS+CDDP-treated mice had significantly higher DFS rate than the BLS+CDDP-treated mice (P = 0.043). Although chemotherapy significantly reduced multiple metastases (P = 0.033), there was no significant correlation between FGS and lung metastasis. Our study showed that FGS significantly reduced the recurrence of the tumor, but did not reduce lung metastasis. To reduce tumor recurrence and multiple metastases, the combination of FGS and chemotherapy may be necessary in the clinic. Citation Format: Shinji Miwa, Yukihiko Hiroshima, Shuya Yano, Yasunori Matsumoto, Fuminari Uehara, Mako Yamamoto, Hiroaki Kimura, Katsuhiro Hayashi, Hiroyuki Tsuchiya, Robert M. Hoffman. Efficacy of fluorescence-guided surgery on primary human osteosarcoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4313. doi:10.1158/1538-7445.AM2014-4313