Benefits of radioimmunoguided surgery for pelvic recurrence
Benefits of radioimmunoguided surgery for pelvic recurrence
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DOI：
10.1053/ejso.2000.1108
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发表时间：
2001-04-01
期刊：
影响因子：
--
通讯作者：
Schneebaum, S
中科院分区：
文献类型：
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作者：
Haddad, R;Avital, S;Schneebaum, S
目的：复发性直肠癌的手术通常具有创伤性，且疗效值得怀疑。研究了使用放射免疫引导手术 (RIGS(R)) 来增强外科医生对这些患者疾病程度的评估。方法：21 名被诊断患有复发性盆腔癌的患者使用 RIGS(R) 系统进行了手术。术前评估包括胸部、腹部和骨盆 CT 以及结肠镜检查。患者被注射了 CC49，一种用 I-125 标记的单克隆抗体 (MoAb)。手术探查后用伽玛探测探针进行调查。结果：手术探查发现 8 例结直肠内复发、9 例结肠外盆腔复发和 5 例盆腔外淋巴结转移。 RIGS 探查证实了除 1 例（无 MoAb 定位的患者）外的所有结肠内复发，确定了 13 例盆腔复发和 10 例淋巴结转移。有 7 名患者出现隐匿性发现（33%），因此需要修改手术程序。手术包括 5 例腹会阴切除术、6 例低位前切除术、7 例骶前肿瘤切除术、8 例全腹部子宫切除术和双侧输卵管卵巢切除术、1 例盆腔廓清术和 1 例术后廓清术。没有手术死亡。 8名患者出现轻微并发症，1名患者出现严重并发症，因漏尿而再次手术。平均随访时间为 18 个月。十名患者死于疾病。结论：尽管 RIGS 不能治愈疾病，但它可以通过更好的疾病分期帮助外科医生做出决策。 (C) 2001 年哈考特出版有限公司。
Aim: Surgery for recurrent rectal cancer is usually traumatic and of questionable curative value. The use of radioimmunoguided surgery (RIGS(R)) in enhancing the surgeon's assessment of the extent of disease in these patients was investigated.Methods: Twenty-one patients diagnosed with recurrent pelvic cancer were operated using the RIGS(R) system. Preoperative assessment included CTs of chest, abdomen and pelvis as well as colonoscopy. Patients were injected with CC49, a monoclonal antibody (MoAb) labelled with I-125. Surgical exploration was followed by survey with the gamma-detecting probe.Results: Surgical exploration identified eight intra-colorectal recurrences, nine extra-colonic pelvic recurrences and five extra-pelvic lymph node metastases. RIGS exploration confirmed all intra-colonic recurrences except for one (patient with no MoAb localization), identified 13 pelvic recurrences and 10 lymph node metastases. There were seven patients with occult findings (33%), resulting in a modified surgical procedure. Surgery included five abdominoperineal resections, six low anterior resections, seven excisions of presacral tumour, eight total abdominal hysterectomy and bilateral salpingo-oophorectomy, one pelvic exenteration and one post-exenteration. There were no operative deaths. Eight patients had minor complications, and one patient had a major complication with reoperation due to urinary leak. The mean follow-up was 18 months. Ten patients died of disease.Conclusion: Although not curative, RIGS can help the surgeon in the decision-making process through better disease staging. (C) 2001 Harcourt Publishers Ltd.