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Mouse experiments characterize surgery-accelerated metastasis in osteosarcoma

OCTOBER 23, 2018
Clinical Congress Daily Highlights, Tuesday Second Edition

Osteosarcoma (OS) is the most common bone tumor in children and young adults. Approximately 30 to 40 percent of patients will develop metastasis, which is mediated in part by macrophage recruitment. While resection of primary tumors is a standard treatment for solid cancers, evidence shows that surgery may promote metastatic growth, known as surgery-accelerated metastasis. On Tuesday afternoon, Michelle P. Kallis, MD, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, presented data from a study examining the effect of surgery on the development of pulmonary metastases in an OS mouse model.

In the study, mice with OS cells implanted into the tibia were randomized into groups to assess the effect of amputation of the primary tumor, amputation of the contralateral limb (to represent surgical stress) and amputation of the primary tumor plus gefitinib, a drug that has previously been shown to suppress growth of macrophage-promoted lung metastases.

After three weeks, mice that underwent amputation of the primary tumor had significantly increased pulmonary metastases compared to controls. Surgical stress, as measured by the mice who underwent amputation of the contralateral limb, did not increase lung metastasis. Those who received gefitinib treatment also did not show increased metastasis.

“Surgery promotes a shift to a more protumor like state, regardless of whether the primary tumor is in place,” Dr. Kallis said. The data support the hypothesis that surgical resection of primary OS tumors accelerates growth of lung metastases, and that gefitinib treatment can mitigate this effect. In addition, the lack of increased metastasis in the mice that underwent amputation of the contralateral limb suggests that the primary tumor may exert inhibitory control of metastases.

To view this study’s abstract, click here.

The Scientific Forum presentation, Surgical Removal of the Primary Tumor Accelerates Pulmonary Metastasis in a Mouse Model of Osteosarcoma, was held October 23 at the 2018 Clinical Congress of the American College of Surgeons in Boston. Program, webcast and audio information is available online at

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