Monoclonal antibodies--why should surgeons be interested?
Many different monoclonal antibodies used experimentally and clinically are highly tumor-specific. Radiolabelling of these antibodies has been successfully accomplished. Immunoscintigraphy of primary and metastatic cancers has a reported sensitivity of 59-70%. However, in many studies, operative and histologic confirmation is lacking. Radioimmunoguided surgery is a promising new adjunctive technique for the surgical treatment of colorectal cancer. Its reported sensitivity ranges between 70 and 100% and specificity between 66 and 100%. In approximately one-third of patients with colorectal cancer, additional intraoperative information concerning the presence of subclinical tumors was gained using radioimmunoguided surgery. This system has the potential to assist the surgeon in performing complete resection of cancer and decrease the local recurrence rate. This could be of particular clinical importance for rectosigmoid tumors where the reported local recurrence rate is as high as 30%. Despite the advances made, many problems still need to be resolved. Radioimmunoguided surgery, however, has the potential to change the way surgery for colorectal cancer is being performed. It offers the possibility of improvement in patient survival.
Brzeziński
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Cross Cancer Institute, Department of Surgery, Edmonton, Alberta, Canada.
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D006801:Humans; D051379:Mice; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D016719:Radioimmunodetection; D013514:Surgical Procedures, Operative / Q000379:methods
D000911:Antibodies, Monoclonal