L’utilizzo della chirurgia radioimmunoguidata nella nostra esperienza


Maria Antonietta Gioffrè Florio, Fausto Famà, Grazia Gullo, Sergio Mazzei, Andrea Pollicino, Paola Scarfò, Angelo Vindigni

Ann. Ital. Chir., 2007; 78: 433-437

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Radio Immuno Guided Surgery (RIGS) is a technique that has numerous uses in oncology. It is characterised by a
multidisciplinary approach by nuclear physician and surgeon for diagnosis and treatment; it uses colloid radiotracers,
monoclonal antibodies or non-immunological tracers. We adopted this technique in 281 patients: 256 (91,9%) (range
26-82) with breast disease (breast cancer or occult breast lesions) and 25 (8,9%) (range 42-84) with colorectal cancer
localized or recurrent.
We used monoclonal antibodies (ArcitumoMab® 99mTc-labelled) for colorectal carcinomas and aggregates of human
serum albumin 99mTc-labelled for Radioguided Occult Lesion Localization (ROLL) and Sentinel Lymph-Node Biopsy
(SLNB). All patients were studied preoperatively by routine blood tests, instrumental exams and tumoral markers. Amongst
patients with breast disease, 142 breast cancers and 114 occult breast lesions were found. Among patients with colorectal
disease, 8 cases had localized colorectal cancer and 17 cases had locoregional recurrence and/or metastasis. In all cases
pathologic sites were detected by probe during surgery.
The RIGS is indicated for ROLL and SLNB; nevertheless it is also suggested for pre- and intraoperatively staging of
primary and recurrent colorectal cancers. This method gives a chance for a radical surgical and oncologic treatment in
localized and recurrent cancer.
Prospective studies are needed in order to estimate survival and usefulness of this methodology.