Radioimmunoguided surgery in primary colorectal carcinoma: An intraoperative prognostic tool and adjuvant to traditional staging

Mark W. Arnold, Donn C. Young, Charles L. Hitchcock, Schlomo Schneebaum, Edward W. Martin

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The prognostic value of traditional staging classification for colorectal cancer has changed little since Dukes created the first staging scheme. Some patients with known metastatic disease are long-term survivors, while other patients with local disease die early. New intraoperative cancer detection technology, the radioimmunoguided surgery (RIGS) system, is being studied as a tool to aid in prediction of patient outcome. Patients and methods: Thirty-one patients with primary colorectal cancer were injected with the monoclonal antibody CC49, which was radiolabeled with iodine 125 (125I). A hand-held gamma-detecting probe was used at surgery to detect the radiolabeled antibody. Patients were classified as to the presence or absence of 125I-CC49-positive residual tissue at the close of surgery. Patient survival was analyzed. Results: Follow-up ranged from 30 to 54 months. Survival of 11 stage I or II patients was longer than in 20 stage III or IV patients (P = 0.019). All 14 patients cleared of RIGS-positive tissue were alive at last follow-up, while 15 of 17 RIGS-positive patients died of their disease (P < 0.0001). Conclusions: The RIGS system used during surgery provides the surgeon with immediate prognostic information on patients with colorectal cancer and supplements traditional pathologic staging.

Original languageEnglish
Pages (from-to)315-318
Number of pages4
JournalAmerican Journal of Surgery
Volume170
Issue number4
DOIs
StatePublished - Oct 1995
Externally publishedYes

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