Radioimmunoguided surgery for colorectal cancer

被引:23
作者
Bertsch, DJ
Burak, WE
Young, DC
Arnold, MW
Martin, WE
机构
[1] OHIO STATE UNIV,ARTHUR G JAMES CANC HOSP,COLUMBUS,OH 43210
[2] OHIO STATE UNIV,DIV SURG ONCOL,COLUMBUS,OH 43210
[3] OHIO STATE UNIV,DIV GEN SURG,COLUMBUS,OH 43210
[4] OHIO STATE UNIV,DEPT SURG,COLUMBUS,OH 43210
[5] OHIO STATE UNIV,DEPT BIOSTAT,CTR COMPREHENS CANC,COLUMBUS,OH 43210
[6] OHIO STATE UNIV,RES INST,COLUMBUS,OH 43210
关键词
RIGS colorectal cancer; disease dissemination; RIGS staging;
D O I
10.1007/BF02306288
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:310 / 316
页数:7
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