title: Radioimmunoguided surgery in primary colorectal carcinoma: an intraoperative prognostic tool and adjuvant to traditional staging.
abstract: BACKGROUND
  The prognostic value of traditional staging classification for colorectal cancer has changed little since Dukes created the first staging scheme. Some patients with known metastatic disease are long-term survivors, while other patients with local disease die early. New intraoperative cancer detection technology, the radioimmunoguided surgery (RIGS) system, is being studied as a tool to aid in prediction of patient outcome.
  
  
  METHODS
  Thirty-one patients with primary colorectal cancer were injected with the monoclonal antibody CC49, which was radiolabeled with iodine 125 (125I). A hand-held gamma-detecting probe was used at surgery to detect the radiolabeled antibody. Patients were classified as to the presence or absence of 125I-CC49-positive residual tissue at the close of surgery. Patient survival was analyzed.
  
  
  RESULTS
  Follow-up ranged from 30 to 54 months. Survival of 11 stage I or II patients was longer than in 20 stage III or IV patients (P = 0.019). All 14 patients cleared of RIGS-positive tissue were alive at last follow-up, while 15 of 17 RIGS-positive patients died of their disease (P < 0.0001).
  
  
  CONCLUSIONS
  The RIGS system used during surgery provides the surgeon with immediate prognostic information on patients with colorectal cancer and supplements traditional pathologic staging.
authors.affiliation: Department of Surgery, Ohio State University, Arthur G. James Cancer Hospital and Research Institute, Columbus, USA.
authors.forename: M W
authors.initials: MW
authors.lastname: Arnold
authors.forename: D C
authors.initials: DC
authors.lastname: Young
authors.forename: C L
authors.initials: CL
authors.lastname: Hitchcock
authors.forename: S
authors.initials: S
authors.lastname: Schneebaum
authors.forename: E W
authors.initials: EW
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D000912:Antibodies, Neoplasm; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016719:Radioimmunodetection; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D000912:Antibodies, Neoplasm; C091202:B72.3 antibody; D007457:Iodine Radioisotopes