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Published on: September 9, 2020
Viability of Tumor Cells in Bone Dust: Implications for Oncologic Skull Base Surgery
Kelly Bridgham1, Hani Samarah1, Emma De Ravin1
1Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Background:
Head and neck tumors with skull base involvement may require drilling of tumor infiltrated bone. We hypothesize that bone dust generated during this process contains viable tumor cells that may seed the surgical field.
Methods:
Tumors with gross bone invasion were drilled, and dust was collected for H&E, cell viability analysis, and single-cell sequencing (scRNAseq). An ultrasonic bone aspirator (UBA) and synthetic barrier were evaluated as methods to decrease dust dispersion.
Results:
H&E confirmed the presence of viable tumor cells in bone dust, while scRNAseq demonstrated keratinocyte and epithelial cells expressing tumor-associated gene sets. UBA decreased viable tumor cell count compared to a drill both on H&E and cell count viability analysis. The synthetic barrier prevented bone dust accumulation on the surrounding field after drilling.
Conclusions:
Viable cancer cells and supporting TME elements can be isolated from bone dust. An UBA or synthetic barrier may reduce dust dispersion and accumulation on the surrounding tissue.
