Fluorescence-guided Surgery with Splenic Preservation Prevents Tumor Recurrence in an Orthotopic Nude-mouse Model of Human Pancreatic Cancer

Aim: The purpose of this study was to investigate whether splenectomy influences tumor recurrence after fluorescence-guided surgery (FGS) in an orthotopic nudemouse model of pancreatic cancer. Materials and Methods: Green fluorescence protein (GFP)-labeled human pancreatic cancer cells (MiaPaCa2-GFP) were subcutaneously injected into the flanks of nude mice. Subcutaneous tumors were harvested and surgical orthotopic implantation (SOI) was performed in the tail of the pancreas with small tumor fragments. FGS was performed 21 days after SOI. Mice were then randomly divided into FGS-only control group (n=7) and FGS plus splenectomy group (n=8). Tumor recurrence was analyzed by laparotomy 21 days after FGS. Results: In the control group, no recurrence was found. In contrast, multiple peritoneal seeded nodules were observed in two mice of the splenectomy group (0% vs. 25%, p=0.467). Conclusion: Postoperative tumor recurrence only occurred in the splenectomy-treated group suggesting that FGS can spare the patient the morbidity of splenectomy.