Dr. Lazarides on Research Regarding Margin Assessment in Sarcoma

Alexander Leandros Lazarides, MD, resident at Duke University Medical Center, discusses research regarding margin assessment in patients with sarcoma.

Negative surgical margins are associated with lower local recurrence and improved overall survival, explains Lazarides. However, it is only after surgery that the pathologist can evaluate a tumor sample to determine whether a negative margin was achieved or not. Results can take up to 2 weeks to return, at which point any residual disease that may have been left behind may have spread.

At Duke, investigators have developed an activatable fluorescent probe that has the potential to assess margins intraoperatively. The fluorescent probe is activated by cathepsin proteases, which are overexpressed in sarcoma, explains Lazarides. Once the primary tumor is taken out, surgeons can insert the probe to detect residual disease. This research has led to the development of a laser ablation system, which has been tested in mice as a way of killing remaining malignant cells, concludes Lazarides.