Improved disease-free survival and overall survival after fluorescence-guided surgery of liver metastasis in an orthotopic nude mouse model.
BACKGROUND
In the present study, we sought to determine if fluorescence-guided surgery (FGS) would improve survival compared to standard bright light surgery (BLS) in an experimental colorectal liver metastasis nude mouse model.


METHODS
Orthotopic nude-mouse models of human HT-29-GFP colon cancer liver metastasis were established in the left lobe of the liver of mice. Fourteen mice with a single liver metastasis were randomized into FGS or BLS groups of seven each. FGS of liver metastasis was performed using a hand-held portable fluorescence imaging system (Dino-Lite) to visualize the GFP fluorescence of the metastasis. The BLS- and FGS-treated mice were followed by weekly fluorescence imaging in order to detect recurrence.


RESULTS
The bright fluorescence of GFP provided sufficient illumination to accurately distinguish the margins of the metastasis within the liver. Recurrence occurred in multiple sites including the liver, lung, and other organs in the BLS-treated mice but was significantly reduced in FGS-treated mice. The FGS-treated mice had significantly prolonged disease-free survival (P = 0.001) and overall survival (P = 0.027) compared to BLS-treated mice.


CONCLUSIONS
The results of the present report demonstrate the feasibility and efficacy of FGS for liver metastasis and suggest its important clinical potential.
AntiCancer, Inc., San Diego, California.|Department of Surgery, University of California San Diego, San Diego, California.|Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
Takashi
T
Murakami
AntiCancer, Inc., San Diego, California.|Department of Surgery, University of California San Diego, San Diego, California.|Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
Yukihiko
Y
Hiroshima
AntiCancer, Inc., San Diego, California.
Yong
Y
Zhang
Department of Surgery, University of California San Diego, San Diego, California.
Michael
M
Bouvet
Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
Takashi
T
Chishima
Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
Kuniya
K
Tanaka
Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
Itaru
I
Endo
AntiCancer, Inc., San Diego, California.|Department of Surgery, University of California San Diego, San Diego, California.
Robert M
RM
Hoffman
D000818:Animals; D018572:Disease-Free Survival; D005240:Feasibility Studies; D019073:HT29 Cells; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008027:Light; D008114:Liver Neoplasms, Experimental / Q000556:secondary / Q000601:surgery*; D051379:Mice; D008819:Mice, Nude; D061848:Optical Imaging / Q000295:instrumentation; D011897:Random Allocation; D016019:Survival Analysis; D016896:Treatment Outcome
HT-29; bright-light surgery (BLS); colon cancer; disease-free survival; fluorescence-guided surgery (FGS); green fluorescent protein (GFP); liver metastasis; orthotopic; survival