Increase of IL-12 following reconstruction for total en bloc spondylectomy using frozen autografts treated with liquid nitrogen

PLoS One. 2013 May 29;8(5):e64818. doi: 10.1371/journal.pone.0064818. Print 2013.

Abstract

Background: Total en bloc spondylectomy (TES) is a surgery designed to achieve complete resection of a malignant spinal tumor such as spinal metastasis. Although this procedure decreases the rate of local recurrence, it is questionable whether local control prolongs patient's survival. We developed a "second-generation TES" that brings about TES enhancing antitumor immunity to prolong patient's survival. Our purpose is to present a second-generation TES applied tumor-induced cryoimmunology and assess the immunity-enhancing effect after implementing this surgery.

Methods: We performed a retrospective review of prospectively collected data in second-generation TES as carried out in 56 cases. In second-generation TES, instead of harvesting autograft from the ilium or fibula, the resected lamina and vertebral body from TES are frozen using liquid nitrogen and used as grafted bone for spinal reconstruction. In recent 26 of the 56 cases, in addition to the TES procedure, a small amount of the tumor tissue from the resected tumor-bearing vertebra was also placed into liquid nitrogen. This small amount of tumor tissue was then implanted subcutaneously on one side of the axilla. In 52 of 56 cases, measurement of interleukin 12 (IL-12) was performed before surgery and at both 1 and 3 months after surgery.

Results: IL-12 increased after TES surgery in 38 of 52 cases (73.1%). The mean IL-12 relative concentrations at both 1 and 3 months after surgery, as compared to before surgery, were significantly higher (121±89 and 149±111%: P<0.05 and P<0.01).

Conclusions: Our results show that second-generation TES may provide not only a local radical cure but also a systemic immunological enhancement. Further prolonged survival in patients with a malignant spinal tumor is promising by second-generation TES.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Transplantation / methods*
  • Cryopreservation / methods
  • Female
  • Fibula / transplantation
  • Follow-Up Studies
  • Humans
  • Ilium / transplantation
  • Interleukin-12 / metabolism*
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Nitrogen
  • Plastic Surgery Procedures / methods*
  • Sacrum / surgery
  • Spinal Neoplasms / metabolism
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / surgery*
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult

Substances

  • Interleukin-12
  • Nitrogen

Grants and funding

This study was funded by a Medical Research Encouragement Prize given by the Japan Medical Association; Japanese Foundation for Multidisciplinary Treatment of Cancer; Princess Takamatsu Cancer Research Fund (11-24316); Astellas Foundation for Research on Metabolic Disorders. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.