Immunoscintigraphy in the surgical management of colorectal cancer

The role of immunoscintigraphy in patients with colorectal cancer is being defined in ongoing clinical trials. Currently, most follow-up examination after "curative" resection of colorectal carcinoma are performed by surgeons, oncologists and gastroenterologists. They are largely focused on detecting recurrent intraluminal disease and measuring serial serum carcinoembryonic antigen (CEA) levels. Although rising CEA is often indicative of nonresectable disease, some patients with elevated CEA levels have no evidence of recurrent disease using conventional diagnostic modalities. In these patients, immunoscintigraphy will probably have a major diagnostic role. In addition, immunoscintigraphy may become valuable in screening patients at high risk for recurrence postoperatively, such as those with Dukes' stage C lesions, aneuploidy, poor tumor differentiation or tumor adhesion to or invasion of adjacent organs. Immunoscintigraphy may allow earlier diagnosis of recurrent disease and permit more targeted follow-up studies. Intensive, timely follow-up of these patients should lead to early detection of recurrent disease at a time when these lesions are still resectable.