title: Radioimmunoguided surgery for colorectal cancer.
abstract: BACKGROUND
  Operations for patients with colorectal cancer are based on traditions established by historical experience. Radioimmunoguided surgery (RIGS) provides new information that challenges these traditions.
  
  
  METHODS
  Thirty-two patients with primary colorectal cancer underwent RIGS after being injected with anti-TAG-72 murine monoclonal antibody CC49 labeled with iodine-125. Sixteen of the patients had all gross tumor and RIGS-positive tissue removed (RIGS-negative group), and 16 had only traditional extirpation of the tumor because RIGS-positive tissue was too diffuse (RIGS-positive group).
  
  
  RESULTS
  In the 16 patients having all RIGS-positive tissue removed, five had traditional regional en bloc resections and 11 had additional extraregional tissues resected. Identification of extraregional disease added two liver resections and 25 lymphadenectomies: 10 of the gastrohepatic ligament, five celia axis, six retroperitoneal, and four iliac. With a median follow-up of 37 months, survival in the RIGS-negative group is 100%. In 14 of 16 patients (87.5%) there is no evidence of disease. In the RIGS-positive group, follow-up shows 14 of 16 patients are dead and two are alive with disease (p < 0.0001).
  
  
  CONCLUSIONS
  These results suggest that RIGS identifies patterns of disease dissemination different from those identified by traditional staging techniques. Removal of additional RIGS-positive tissues in nontraditional areas may improve survival.
authors.affiliation: Division of Surgical Oncology, Arthur G. James Cancer Hospital and Research Institute, Ohio State University, Columbus, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Bertsch
authors.forename: W E
authors.initials: WE
authors.lastname: Burak
authors.forename: D C
authors.initials: DC
authors.lastname: Young
authors.forename: M W
authors.initials: MW
authors.lastname: Arnold
authors.forename: E W
authors.initials: EW
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016719:Radioimmunodetection