Abstract
Background: Operations for patients with colorectal cancer are based on traditions established by historical experience. Radioimmunoguided surgery (RIGS) provides new information that challenges these traditions.
Methods: Thirty-two patients with primary colorectal cancer underwent RIGS after being injected with anti-TAG-72 murine monoclonal antibody CC49 labeled with iodine-125. Sixteen of the patients had all gross tumor and RIGS-positive tissue removed (RIGS-negative group), and 16 had only traditional extirpation of the tumor because RIGS-positive tissue was too diffuse (RIGS-positive group).
Results: In the 16 patients having all RIGS-positive tissue removed, five had traditional regional en bloc resections and 11 had additional extraregional tissues resected. Identification of extraregional disease added two liver resections and 25 lymphadenectomies: 10 of the gastrohepatic ligament, five celiac axis, six retroperitoneal, and four iliac. With a median follow-up of 37 months, survival in the RIGS-negative group is 100%. In 14 of 16 patients (87.5%) there is no evidence of disease. In the RIGS-positive group, follow-up shows 14 of 16 patients are dead and two are alive with disease (p<0.0001).
Conclusion: These results suggest that RIGS identifies patterns of disease dissemination different from those identified by traditional staging techniques. Removal of additional RIGS-positive tissues in nontraditional areas may improve survival.
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All authors of this article are paid consulting fees by Neoprobe Corporation, Dublin, Ohio. Neoprobe is the supplier of the CC49 monoclonal antibody and the Neoprobe 1000 instrument and funds studies with the RIGS technology. In addition, Dr. Martin is a cofounder of Neoprobe.
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Bertsch, D.J., Burak, W.E., Young, D.C. et al. Radioimmunoguided surgery for colorectal cancer. Annals of Surgical Oncology 3, 310–316 (1996). https://doi.org/10.1007/BF02306288
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DOI: https://doi.org/10.1007/BF02306288