New concept of limb salvage surgery in musculoskeletal sarcomas with acridine orange therapy

Katsuyuki Kusuzaki, Shigekuni Hosogi, Eishi Ashihara, Takao Matsubara, Haruhiko Satonaka, Tomoki Nakamura, Akihiko Matsumine, Akihiro Sudo, Atsumasa Uchida, Hiroaki Murata, Nicola Baldini, Stefano Fais, Yoshinori Marunaka

Research output: Chapter in Book/Report/Conference proceedingChapter


Although limb salvage surgery involving wide resection and limb reconstruction for musculoskeletal sarcomas is well established for low risk of local tumor recurrence, limb function is unsatisfactory for many patients because of the disability in active athletics such as running, jumping, throwing, swimming etc. To avoid poor limb function caused by surgery, it is important to preserve normal nerves, vessels, bones, joints and muscles adjacent to tumor as possible as we can, supported by effective adjuvant therapy to inhibit local tumor recurrence. To develop minimally-invasive limb salvage surgery with minimal damage of normal tissues and low risk of local recurrence, we have recently established a new limb salvage modality of acridine orange (AO) therapy (AOT) based on photodynamic surgery (PDS), photodynamic therapy (PDT) and radiodynamic therapy (RDT) using AO in patients with high-grade malignant musculoskeletal sarcoma. Clinical outcomes of the study showed that: 1) low risk of local recurrence which is almost the same as that with conventional wide resection, and 2) superior limb function to that by wide resection. In this chapter, we present mechanisms of cytocidal effects of AOT based on experimental research and clinical outcome of AOT applied to musculoskeletal sarcoma patients.

Original languageEnglish
Title of host publicationSarcoma: Symptoms, Causes and Treatments
PublisherNova Science Publishers, Inc.
Number of pages15
ISBN (Print)9781621003625
Publication statusPublished - Jan 2012

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)


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