TY - JOUR
T1 - Radioimmunoguided surgery benefits in carcinoembryonic antigen-directed second-look surgery in the asymptomatic patient after curative resection of colorectal cancer
AU - Bertoglio, Sergio
AU - Benevento, Angelo
AU - Percivale, Pierluigi
AU - Cafiero, Ferdinando
AU - Moresco, Luciano
AU - Peressini, Alberto
AU - Dionigi, Renzo
AU - Badellino, Fausto
PY - 1998
Y1 - 1998
N2 - Radioimmunoguided surgery (RIGS) with radiolabeled monoclonal antibodies (MoAbs) has been reported as useful in second-look colorectal cancer procedures to improve surgical decision-making by helping avoid needless extensive surgery and expanding curative resection to sites of recurrence that have been missed previously. Sixteen asymptomatic patients with an history of colorectal cancer surgery underwent second-look surgery using the RIGS system, solely on the basis of rising serum levels of carcinoembryonic antigen (CEA). All patients were injected preoperatively with the anti- tumor-associated glycoprotein (TAG) 125I-labeled MoAb B72.3. Both traditional and RIGS exploration were used to determine the extension of a possible recurrence and its resectability for cure. Recurrent disease was observed in 14 of the 16 patients as the result of this combined exploration. Exploration alone showed the presence of recurrent disease in 9 of 16 patients (56.2%). Thus, RIGS found overlooked tumor in five patients (31.2%). All the additional RIGS-detected tumor sites were locoregional recurrences resectable for cure; conversely, no diagnostic improvements were shown in patients with liver metastases. Resection for cure was obtained by this approach in 9 of 16 patients (56.2%). Two patients without disease at the exploratory laparotomy recurred within 2 months at sites away from the abdomen. RIGS improved the results of colorectal cancer CEA-guided second- look procedures in asymptomatic patients by recruiting one-third of patients to curative resections.
AB - Radioimmunoguided surgery (RIGS) with radiolabeled monoclonal antibodies (MoAbs) has been reported as useful in second-look colorectal cancer procedures to improve surgical decision-making by helping avoid needless extensive surgery and expanding curative resection to sites of recurrence that have been missed previously. Sixteen asymptomatic patients with an history of colorectal cancer surgery underwent second-look surgery using the RIGS system, solely on the basis of rising serum levels of carcinoembryonic antigen (CEA). All patients were injected preoperatively with the anti- tumor-associated glycoprotein (TAG) 125I-labeled MoAb B72.3. Both traditional and RIGS exploration were used to determine the extension of a possible recurrence and its resectability for cure. Recurrent disease was observed in 14 of the 16 patients as the result of this combined exploration. Exploration alone showed the presence of recurrent disease in 9 of 16 patients (56.2%). Thus, RIGS found overlooked tumor in five patients (31.2%). All the additional RIGS-detected tumor sites were locoregional recurrences resectable for cure; conversely, no diagnostic improvements were shown in patients with liver metastases. Resection for cure was obtained by this approach in 9 of 16 patients (56.2%). Two patients without disease at the exploratory laparotomy recurred within 2 months at sites away from the abdomen. RIGS improved the results of colorectal cancer CEA-guided second- look procedures in asymptomatic patients by recruiting one-third of patients to curative resections.
KW - Adenocarcinoma
KW - Carcinoembryonic antigen
KW - Colonic neoplasms
KW - Colorectal neoplasms
KW - Intraoperative period
KW - Iodine radioisotopes
KW - Local neoplasm recurrence
KW - Monoclonal antibodies
KW - Neoplasm metastasis
KW - Neoplasm staging
KW - Patient selection
KW - Radioimmunodetection
KW - Rectal neoplasms
KW - Reoperation
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U2 - 10.1002/(SICI)1098-2388(199812)15:4<263::AID-SSU15>3.0.CO;2-Q
DO - 10.1002/(SICI)1098-2388(199812)15:4<263::AID-SSU15>3.0.CO;2-Q
M3 - Article
C2 - 9829384
AN - SCOPUS:0031789779
VL - 15
SP - 263
EP - 267
JO - Seminars in Surgical Oncology
JF - Seminars in Surgical Oncology
SN - 8756-0437
IS - 4
ER -