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Radioimmunoguided surgery for recurrent colorectal cancer manifested by isolated CEA elevation
S Avital1, R Haddad, A Troitsa
1Dept. of Surgery "A," Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel-Aviv 64239, Israel.
Cancer
|October 24, 2000
Summary
Radioimmunoguided surgery aids in detecting recurrent colorectal cancer when only carcinoembryonic antigen (CEA) is elevated. This technique confirmed all tumors and revealed additional sites, improving surgical planning for patients with suspected recurrence.
Area of Science:
- Oncology
- Surgical Oncology
- Nuclear Medicine
Background:
- Carcinoembryonic antigen (CEA) is a sensitive marker for colorectal carcinoma recurrence.
- Elevated CEA can precede imaging detection of recurrent cancer.
- Surgeons often hesitate to operate based solely on increased CEA levels.
Purpose of the Study:
- To investigate radioimmunoguided surgery (RIGS) for detecting intra-abdominal disease.
- To assess RIGS's ability to enhance surgeon's detection of recurrent colorectal cancer.
- To evaluate RIGS in patients with elevated CEA and negative standard imaging.
Main Methods:
- Nineteen patients with suspected recurrence (elevated CEA, negative colonoscopy/CT) underwent RIGS.
- Patients received scintigraphy with anti-CEA monoclonal antibody (MoAb) labeled with (99m)Tc or Indium I-111.
- A gamma-detecting probe was used during surgery after traditional exploration.
Main Results:
- Traditional exploration found 26 recurrent tumors.
- RIGS confirmed all identified tumors and detected additional sites in 7 patients, altering surgical plans.
- CEA scans showed correlation with intra-abdominal findings in 7 patients.
Conclusions:
- Surgery is recommended for patients with elevated CEA and no other findings.
- Radioimmunoguided surgery should be utilized to improve understanding of disease extent.
- RIGS enhances surgical decision-making in recurrent colorectal cancer detection.