Abstract
Radioimmunoguided surgery (RIGS) is an intraoperative diagnostic method based on monoclonal antibodies (MoAb) labeled with a radioactive isotope (125I). Twenty colorectal cancer pts (12 recurrent, 8 primary) were injected with an anti-TAG (tumor-associated glycoprotein) MoAb, CC49 125I. Workup included colonoscopy, abdominal and chest CTs. Intraoperative traditional surgeon's exploration, including liver US, was followed by a gamma-detecting probe (Neoprobe 1000) survey. The MoAb localized on the tumor in 100% of pts. In addition to the primary lesions, CT identified 6 tumor sites, the surgeon 21 sites, RIGS 48 sites—36 confirmed by Pathology (H&E). In 9/20 pts (45%) RIGS detected occult findings (H&E-confirmed). These included lymph nodes, anastomosis, pelvis, uterus and peritoneum in 8/12 (66.6%) recurrent pts, and 1/8 (12.5%) primary pts, and changed the surgical plan in 10/20 (50%) pts. Thus, RIGS surgery can lead to a non-randomized more rational approach when selecting radical or non-radical surgery for colorectal cancer.
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