RADIOIMMUNOGUIDED SURGERY FOR COLORECTAL-CANCER

BACKGROUND: Improving the survival rate of surgical treatments of canc er depends upon accurate staging of disease and the subsequent ability to completely resect the lesions. Radioimmunoguided surgery (RIGS) ha s been employed in the treatment of colon and rectal cancer, and a mul ticenter trial is under way. METHODS: Twenty-eight patients with eithe r primary or recurrent colorectal cancer were injected with the monocl onal antibody CC49 labeled with iodine 125. A hand-held gamma-detectin g probe was used intraoperatively to detect radiolabeled antibody. At surgery the patients underwent both traditional and RIGS explorations. RESULTS: RIGS detected radiolabeled antibody in 73% (14 of 19) of pat ients with primary colorectal cancer and in 100% (7 of 7) of patients with recurrent disease. Based on RIGS, 26% (5 of 19) of patients with primary cancer were upstaged from stage I/II to stage III/IV. CONCLUSI ONS: Although the final results of this phase III trial are incomplete , RIGS appears to provide immediate, valuable information that is not available from more conventional methods. (C) 1997 by Excerpta Medica, Inc.