title: Radioimmunoguided surgery in recurrent colorectal cancer: the role of carcinoembryonic antigen, computerized tomography, and physical examination.
abstract: From January 1986 to December 1987, 32 patients with recurrent colorectal cancer had second-look radioimmunoguided surgery (RIGS system). All patients had pathologic confirmation of recurrence. The RIGS system identified 81% of recurrences, and in six patients recurrent tumor was identified only by RIGS. All patients had physical examination, carcinoembryonic antigen (CEA) assay, and computerized tomography of the abdomen and pelvis. Detection of recurrence was based on symptoms in six, elevated CEA value in 25, and physical examination in one. The CEA was elevated preoperatively in 30 patients; two false-negative results occurred in symptomatic patients who had pelvic recurrence. The median CEA value in those with liver recurrence was 30 ng/ml (range 5.2 to 298) and for pelvic recurrence 13 ng/ml (range 1.9 to 31) (P less than .05). The overall sensitivity of CT was 41% (abdomen other than liver 37%, liver 56%, and pelvis 22%). The combination of elevated CEA, symptoms, and physical findings identified 100% of recurrences. We conclude that a rising CEA remains the most accurate indicator of recurrence. CT should not be done routinely to detect recurrent colorectal cancer unless CEA is elevated or the patient is symptomatic. In our study the intraoperative use of the RIGS system aided the surgeon in identifying occult tumors.
authors: Department of Surgery, Ohio State University College of Medicine, Columbus.
authors: A
authors: A
authors: Sardi
authors: C M
authors: CM
authors: Agnone
authors: C A
authors: CA
authors: Nieroda
authors: C
authors: C
authors: Mojzisik
authors: G
authors: G
authors: Hinkle
authors: P
authors: P
authors: Ferrara
authors: W B
authors: WB
authors: Farrar
authors: J
authors: J
authors: Bolton
authors: M O
authors: MO
authors: Thurston
authors: E W
authors: EW
authors: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic / Q000295:instrumentation / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010808:Physical Examination; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed
chemical_list: D000911:Antibodies, Monoclonal; D002272:Carcinoembryonic Antigen; D007457:Iodine Radioisotopes