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The impact of radioimmunoguided surgery (RIGSTM) on surgical decision-making in colorectal cancer

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

Radioimmunoguided surgery (RIGS system) was performed in ten patients with rectal or low sigmoid colon carcinoma with the use of a hand-held gamma detector (NeoprobeTM 1000) intraoperatively and externally after injection of radiolabeled (125I) monoclonal antibody to detect pelvic and metastatic tumor. Fifteen procedures, including six exploratory laparotomies, four transperineal explorations, two transsacral explorations, one transvaginal biopsy, one brachytherapy, and one transanal polypectomy, were performed. Two patients had previous low anterior resection, seven abdominoperineal resection, and one a rectal polypectomy. Five patients had previous pelvic radiation therapy. Reoperation was indicated by elevated CEA levels in seven patients (70 percent), persistent pelvic pain in six (60 percent), and a suspicious radiologic study in seven (70 percent). RIGS system localized tumors verified by histopatholoy in all ten patients (100 percent); one patient with a positive CT scan and probe findings lacked histopathologic confirmation on frozen section, but had a tumor confirmed on permanent histology. Five major abdominal operations were avoided; in five patients major modifications were made in the surgical procedure based on probe findings. Six received chemotherapy or radiation therapy based on findings of the RIGS system. In six patients with negative or equivocal CT scans, the RIGS system localized histopathologically confirmed tumor. Major abdominal procedures can be avoided, the surgical approach modified, and other modes of therapy instituted earlier with the use of the RIGS system.

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Authors and Affiliations

  1. From the Department of Surgery, Division of Surgical Oncology, The Ohio State University College of Medicine, N-908 Doan Hall, 410 West Tenth Avenue, 43210, Columbus, Ohio

    Carol A. Nieroda M.D. (American Cancer Society Fellows), Cathy Mojzisik R.N., M.S., Armando Sardi M.D. (American Cancer Society Fellows), Peter Ferrara M.D. (American Cancer Society Fellows), George Hinkle R.Ph., M.S., Marlin O. Thurston Ph.D. &  Edward W. Martin Jr. M.D.

Authors
  1. Carol A. Nieroda M.D.
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  2. Cathy Mojzisik R.N., M.S.
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  3. Armando Sardi M.D.
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  4. Peter Ferrara M.D.
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  5. George Hinkle R.Ph., M.S.
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  6. Marlin O. Thurston Ph.D.
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  7. Edward W. Martin Jr. M.D.
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Additional information

Read at the meeting of the American Society of Colon and Rectal Surgeons, Anaheim, California, June 12 to 17, 1988.

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Nieroda, C.A., Mojzisik, C., Sardi, A. et al. The impact of radioimmunoguided surgery (RIGSTM) on surgical decision-making in colorectal cancer. Dis Colon Rectum 32, 927–932 (1989). https://doi.org/10.1007/BF02552267

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  • DOI: https://doi.org/10.1007/BF02552267

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