TY - JOUR
T1 - Benefits of radioimmunoguided surgery for pelvic recurrence
AU - Haddad, R.
AU - Avital, S.
AU - Troitsa, A.
AU - Chen, J.
AU - Baratz, M.
AU - Brazovsky, E.
AU - Gitstein, G.
AU - Kashtan, H.
AU - Skornick, Y.
AU - Schneebaum, S.
PY - 2001
Y1 - 2001
N2 - Aim: Surgery for recurrent rectal cancer is usually traumatic and of questionable curative value. The use of radioimmunoguided surgery (RIGS®) in enhancing the surgeon's assessment of the extent of disease in these patients was investigated. Methods: Twenty-one patients diagnosed with recurrent pelvic cancer were operated using the RIGS® system. Preoperative assessment included CTs of chest, abdomen and pelvis as well as colonoscopy. Patients were injected with CC49, a monoclonal antibody (MoAb) labelled with 125I. Surgical exploration was followed by survey with the gamma-detecting probe. Results: Surgical exploration identified eight intra-colorectal recurrences, nine extra-colonic pelvic recurrences and five extra-pelvic lymph node metastases. RIGS exploration confirmed all intra-colonic recurrences except for one (patient with no MoAb localization), identified 13 pelvic recurrences and 10 lymph node metastases. There were seven patients with occult findings (33%), resulting in a modified surgical procedure. Surgery included five abdominoperineal resections, six low anterior resections, seven excisions of presacral tumour, eight total abdominal hysterectomy and bilateral salpingo-oophorectomy, one pelvic exenteration and one post-exenteration. There were no operative deaths. Eight patients had minor complications, and one patient had a major complication with reoperation due to urinary leak. The mean follow-up was 18 months. Ten patients died of disease. Conclusion: Although not curative, RIGS can help the surgeon in the decision-making process through better disease staging.
AB - Aim: Surgery for recurrent rectal cancer is usually traumatic and of questionable curative value. The use of radioimmunoguided surgery (RIGS®) in enhancing the surgeon's assessment of the extent of disease in these patients was investigated. Methods: Twenty-one patients diagnosed with recurrent pelvic cancer were operated using the RIGS® system. Preoperative assessment included CTs of chest, abdomen and pelvis as well as colonoscopy. Patients were injected with CC49, a monoclonal antibody (MoAb) labelled with 125I. Surgical exploration was followed by survey with the gamma-detecting probe. Results: Surgical exploration identified eight intra-colorectal recurrences, nine extra-colonic pelvic recurrences and five extra-pelvic lymph node metastases. RIGS exploration confirmed all intra-colonic recurrences except for one (patient with no MoAb localization), identified 13 pelvic recurrences and 10 lymph node metastases. There were seven patients with occult findings (33%), resulting in a modified surgical procedure. Surgery included five abdominoperineal resections, six low anterior resections, seven excisions of presacral tumour, eight total abdominal hysterectomy and bilateral salpingo-oophorectomy, one pelvic exenteration and one post-exenteration. There were no operative deaths. Eight patients had minor complications, and one patient had a major complication with reoperation due to urinary leak. The mean follow-up was 18 months. Ten patients died of disease. Conclusion: Although not curative, RIGS can help the surgeon in the decision-making process through better disease staging.
KW - Pelvic recurrence
KW - Radioimmunoguided surgery
UR - http://www.scopus.com/inward/record.url?scp=0034940840&partnerID=8YFLogxK
U2 - 10.1053/ejso.2000.1108
DO - 10.1053/ejso.2000.1108
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AN - SCOPUS:0034940840
SN - 0748-7983
VL - 27
SP - 298
EP - 301
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 3
ER -