Radioimmunoguided surgery in recurrent colorectal cancer: The role of carcinoembryonic antigen, computerized tomography, and physical examination

Journal Article · Sun Oct 01 04:00:00 EDT 1989 · Southern Medical Journal; (USA)

DOI:https://doi.org/10.1097/00007611-198910000-00009· OSTI ID:5261945

Sardi, A; Nieroda, C A; Mojzisik, C; Hinkle, G; Ferrara, P; Farrar, W B; Bolton, J; Thurston, M O; Martin, Jr, E W ^[1]

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1. Ohio State Univ. College of Medicine, Columbus (USA)

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.

• OSTI ID: 5261945
• Journal Information: Southern Medical Journal; (USA), Journal Name: Southern Medical Journal; (USA) Vol. 82:10; ISSN SMJOA; ISSN 0038-4348
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ANTIBODIES
ANTIGENS
BODY
CARCINOEMBRYONIC ANTIGEN
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
GASTROINTESTINAL TRACT
INTESTINES
IODINE ISOTOPES
ISOTOPES
LARGE INTESTINE
MONOCLONAL ANTIBODIES
NEOPLASMS
ORGANS
PATIENTS
RECTUM
TOMOGRAPHY