title: Fluorescence-guided surgery of prostate cancer bone metastasis.
abstract: BACKGROUND
  The aim of this study is to investigate the effectiveness of fluorescence-guided surgery (FGS) of prostate cancer experimental skeletal metastasis.
  
  
  METHODS
  Green fluorescent protein-expressing PC-3 human prostate cancer cells (PC-3-green fluorescent protein) were injected into the intramedullary cavity of the tibia in 32 nude mice. After 2 wk, 16 of the mice underwent FGS; the other 16 mice underwent bright-light surgery (BLS). Half of BLS and FGS mice (8 mice in each group) received zoledronic acid (ZOL). Weekly fluorescence imaging of the mice was performed. Six weeks after surgery, metastases to lung and inguinal lymph node were evaluated by fluorescence imaging.
  
  
  RESULTS
  The percentage of residual tumor after BLS and FGS was 9.9 ± 2.2% and 0.9 ± 0.3%, respectively (P < 0.001). FGS reduced recurrent cancer growth compared with BLS (P < 0.005). Although FGS alone had no significant effect on inguinal lymph node metastases, lung metastasis or disease-free survival (DFS), ZOL in combination with FGS significantly increased DFS (P = 0.01) in comparison with the combination of BLS and ZOL. ZOL reduced lymph node metastases (P = 0.033) but not lung metastasis.
  
  
  CONCLUSIONS
  FGS significantly reduced recurrence of experimental prostate cancer bone metastasis compared with BLS. The combination of FGS and ZOL increased DFS over BLS and ZOL. ZOL inhibited lymph node metastasis but not lung metastasis.
authors: AntiCancer, Inc, San Diego, California; Department of Surgery, University of California, San Diego, San Diego, California; Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
authors: Shinji
authors: S
authors: Miwa
authors: Department of Surgery, University of California, San Diego, San Diego, California.
authors: Yasunori
authors: Y
authors: Matsumoto
authors: AntiCancer, Inc, San Diego, California; Department of Surgery, University of California, San Diego, San Diego, California.
authors: Yukihiko
authors: Y
authors: Hiroshima
authors: AntiCancer, Inc, San Diego, California; Department of Surgery, University of California, San Diego, San Diego, California.
authors: Shuya
authors: S
authors: Yano
authors: AntiCancer, Inc, San Diego, California; Department of Surgery, University of California, San Diego, San Diego, California.
authors: Fuminari
authors: F
authors: Uehara
authors: AntiCancer, Inc, San Diego, California; Department of Surgery, University of California, San Diego, San Diego, California.
authors: Mako
authors: M
authors: Yamamoto
authors: AntiCancer, Inc, San Diego, California.
authors: Yong
authors: Y
authors: Zhang
authors: Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
authors: Hiroaki
authors: H
authors: Kimura
authors: Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
authors: Katsuhiro
authors: K
authors: Hayashi
authors: Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
authors: Norio
authors: N
authors: Yamamoto
authors: Department of Surgery, University of California, San Diego, San Diego, California. Electronic address: mbouvet@ucsd.edu.
authors: Michael
authors: M
authors: Bouvet
authors: Department of Physiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
authors: Naotoshi
authors: N
authors: Sugimoto
authors: Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
authors: Hiroyuki
authors: H
authors: Tsuchiya
authors: AntiCancer, Inc, San Diego, California; Department of Surgery, University of California, San Diego, San Diego, California.
authors: Robert M
authors: RM
authors: Hoffman
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery*; D000818:Animals; D050071:Bone Density Conservation Agents / Q000494:pharmacology; D001859:Bone Neoplasms / Q000556:secondary* / Q000601:surgery*; D045744:Cell Line, Tumor; D004164:Diphosphonates / Q000494:pharmacology; D004195:Disease Models, Animal; D018572:Disease-Free Survival; D049452:Green Fluorescent Proteins / Q000235:genetics; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology; D008164:Luminescent Proteins / Q000235:genetics; D008207:Lymphatic Metastasis; D008297:Male; D008819:Mice, Nude; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000601:surgery; D018365:Neoplasm, Residual / Q000517:prevention & control* / Q000601:surgery; D061848:Optical Imaging / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology*; D000077211:Zoledronic Acid; D000097573:Red Fluorescent Protein
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D049452:Green Fluorescent Proteins; D007093:Imidazoles; D008164:Luminescent Proteins; D000077211:Zoledronic Acid; D000097573:Red Fluorescent Protein
keywords: Bone metastasis; Bright-light surgery; Fluorescence-guided surgery; GFP; Nude mice; Prostate cancer; Zoledronic acid