Fluorescence-Guided Surgery of Retroperitoneal-Implanted Human Fibrosarcoma in Nude Mice Delays or Eliminates Tumor Recurrence and Increases Survival Compared to Bright-Light Surgery

The aim of this study is to determine if fluorescence-guided surgery (FGS) can eradicate human fibrosarcoma growing in the retroperitoneum of nude mice. One week after retroperitoneal implantation of human HT1080 fibrosarcoma cells, expressing green fluorescent protein (GFP) (HT-1080-GFP), in nudemice, bright-light surgery (BLS) was performed on all tumorbearing mice (n = 22). After BLS, mice were randomized into 2 treatment groups; BLS-only (n = 11) or the combination of BLS + FGS (n = 11). The residual tumors remaining after BLS were resected with FGS using a hand-held portable imaging systemunder fluorescence navigation. The average residual tumor area after BLS + FGS was significantly smaller than after BLS-only (0.4 +/- 0.4 mm(2) and 10.5 +/- 2.4 mm(2), respectively; p = 0.006). Five weeks after surgery, the fluorescent-tumor areas of BLS-and BLS + FGS-treated mice were 379 +/- 147 mm(2) and 11.7 +/- 6.9 mm(2), respectively, indicating that FGS greatly inhibited tumor recurrence compared to BLS. The combination of BLS + FGS significantly decreased fibrosarcoma recurrence compared to BLS-only treated mice (p < 0.001). Mice treated with BLS + FGS had a significantly higher disease-free survival rate than mice treated with BLS-only at five weeks after surgery. These results suggest that combination of BLS + FGS significantly reduced the residual fibrosarcoma volume after BLS and improved disease-free survival.