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Probe Guided Surgery for Colorectal Cancer

  • Conference paper
Lymphatic Metastasis and Sentinel Lymphonodectomy

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 157))

Abstract

Anti-CEA-scintigraphy turned out to be very reliable in detecting primary and recurrent colorectal cancer, its overall accuracy being more than 90%. The intraoperative application of this technology should provide similar results when focussing at extrahepatic tumor deposits, for example in lymph nodes, thus allowing accurate staging of the underlying disease. To test this hypothesis we launched the following feasibility study the results of which are compared to those reported in the recent literature.

We investigated 20 patients, six with rectum and 14 with colon cancer. 24 hours before surgery they were intravenously given 1 ml of a fab’-fragment-antibody to CEA, labeled with 25 mCi of 99mTc (CEA-Scan™). During surgery the radioactivity in lymph glands regional to the tumors was measured and compared to the much lower activity in healthy nodes.

For this we used a scintillation probe (C-Trak™, Care Wise, Inc., Morgan Hill, CA). All lymph nodes of interest were then excised and submitted to frozen section pathology. In 7 out of 20 cases scintimetry led to an up-staging of the disease. In addition we found metastatic spread to lymph nodes that were basically not regional to the primary tumor (retroperitoneum, renal hilum etc.).

Scintimetry can precisely identify even very small tumor deposits. So it leads to accurate staging while surgery is still ongoing. In a further step the concept of sentinel node diagnosis, which is right now being clinically evaluated, may some day be applied in colorectal surgical oncology.

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Author information

Authors and Affiliations

  1. Department of Surgery, Community Hospital of Klosterneuburg, Kreutzergasse 12-14, 3400, Klosterneuburg, Austria

    P. Lechner & H. Haushofer

  2. Public Hospital of Klagenfurt, Institute of Nuclear Medicine, St. Veiter-Str. 12, 9020, Klagenfurt, Austria

    P. Lind

  3. Immunomedics, Inc. World Headquarters, 300 American Road, Morris Plains, New Jersey, 07950, USA

    M. Snyder

Authors
  1. P. Lechner
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  2. P. Lind
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  3. M. Snyder
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  4. H. Haushofer
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Editor information

Editors and Affiliations

  1. Klinik für Chirurgie und chirurgische Onkologie Robert-Rössle-Klinik, Universitätsklinikum Charité, Lindenberger Weg 80, 13122, Berlin, Germany

    Peter M. Schlag

  2. Istituto Europeo di Oncologia, Via Ripamonti 435, 20141, Milano, Italy

    Umberto Veronesi MD, PhD.

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© 2000 Springer-Verlag Berlin Heidelberg

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Lechner, P., Lind, P., Snyder, M., Haushofer, H. (2000). Probe Guided Surgery for Colorectal Cancer. In: Schlag, P.M., Veronesi, U. (eds) Lymphatic Metastasis and Sentinel Lymphonodectomy. Recent Results in Cancer Research, vol 157. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57151-0_24

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  • DOI: https://doi.org/10.1007/978-3-642-57151-0_24

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63070-5

  • Online ISBN: 978-3-642-57151-0

  • eBook Packages: Springer Book Archive

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