title: Antigen-directed cancer surgery for primary colorectal cancer: 15-year survival analysis.
abstract: BACKGROUND
  Tumor-associated glycoprotein-72 (TAG-72) is a mucin-like high-molecular-weight glycosylated protein complex overexpressed by many adenocarcinomas. Antigen-directed cancer surgery using radiolabeled anti-TAG-72 murine monoclonal antibodies (muMAbs) has been previously investigated for colorectal cancer. Survival analysis of primary colorectal cancer patients with a minimum of 15-year follow-up after antigen-directed cancer surgery was performed to assess the impact of complete surgical resection of all detectable radiolabeled anti-TAG-72 muMAb.
  
  
  METHODS
  Survival analysis was performed on 92 patients (study group) with primary colorectal cancer (July 1990 to August 1995) treated with antigen-directed cancer surgery using (125)I-labeled anti-TAG-72 muMAb. The study group was subdivided into those with no detectable TAG-72 antigen-bearing tissues (TAG-72 negative, N=33) and those with persistent detectable TAG-72 antigen-bearing tissues (TAG-72 positive, N=59) at completion of surgery. Comparisons were made with a control group (546 patients) from the same time period.
  
  
  RESULTS
  Study group and control group were demographically similar, as were TAG-72-negative subgroup and TAG-72-positive subgroup. TAG-72-negative subgroup had significantly improved median survival (8.8 versus 2.5 years; P=0.005) and time-dependent survival (45.4% versus 22.0% at 10 years; P=0.002 and 39.4% versus 20.3% at 15 years; P=0.003) compared with TAG-72-positive subgroup. TAG-72 positivity was as an independent predictor of long-term mortality risk, when controlled for pathologic stage of disease.
  
  
  CONCLUSIONS
  Absence of detectable TAG-72 antigen within the surgical field at completion of antigen-directed cancer surgery for primary colorectal cancer is of significant prognostic value, conferring a long-term survival advantage to those in whom complete surgical removal of all tissues with detectable radiolabeled anti-TAG-72 muMAb was accomplished.
authors: Division of Surgical Oncology, Department of Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA, stephen.povoski@osumc.edu
authors: Stephen P
authors: SP
authors: Povoski
authors: Ioannis S
authors: IS
authors: Hatzaras
authors: Cathy M
authors: CM
authors: Mojzisik
authors: Mark W
authors: MW
authors: Arnold
authors: George H
authors: GH
authors: Hinkle
authors: Charles L
authors: CL
authors: Hitchcock
authors: Donn C
authors: DC
authors: Young
authors: Edward W
authors: EW
authors: Martin
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm / Q000276:immunology*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D007457:Iodine Radioisotopes; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm; D006023:Glycoproteins; D007457:Iodine Radioisotopes; C047052:tumor-associated antigen 72