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Antigen-directed cancer surgery for primary colorectal cancer: 15-year survival analysis.

AbstractBACKGROUND:
Tumor-associated glycoprotein-72 (TAG-72) is a mucin-like high-molecular-weight glycosylated protein complex overexpressed by many adenocarcinomas. Antigen-directed cancer surgery using radiolabeled anti-TAG-72 murine monoclonal antibodies (muMAbs) has been previously investigated for colorectal cancer. Survival analysis of primary colorectal cancer patients with a minimum of 15-year follow-up after antigen-directed cancer surgery was performed to assess the impact of complete surgical resection of all detectable radiolabeled anti-TAG-72 muMAb.
METHODS:
Survival analysis was performed on 92 patients (study group) with primary colorectal cancer (July 1990 to August 1995) treated with antigen-directed cancer surgery using (125)I-labeled anti-TAG-72 muMAb. The study group was subdivided into those with no detectable TAG-72 antigen-bearing tissues (TAG-72 negative, N=33) and those with persistent detectable TAG-72 antigen-bearing tissues (TAG-72 positive, N=59) at completion of surgery. Comparisons were made with a control group (546 patients) from the same time period.
RESULTS:
Study group and control group were demographically similar, as were TAG-72-negative subgroup and TAG-72-positive subgroup. TAG-72-negative subgroup had significantly improved median survival (8.8 versus 2.5 years; P=0.005) and time-dependent survival (45.4% versus 22.0% at 10 years; P=0.002 and 39.4% versus 20.3% at 15 years; P=0.003) compared with TAG-72-positive subgroup. TAG-72 positivity was as an independent predictor of long-term mortality risk, when controlled for pathologic stage of disease.
CONCLUSIONS:
Absence of detectable TAG-72 antigen within the surgical field at completion of antigen-directed cancer surgery for primary colorectal cancer is of significant prognostic value, conferring a long-term survival advantage to those in whom complete surgical removal of all tissues with detectable radiolabeled anti-TAG-72 muMAb was accomplished.
AuthorsStephen P Povoski, Ioannis S Hatzaras, Cathy M Mojzisik, Mark W Arnold, George H Hinkle, Charles L Hitchcock, Donn C Young, Edward W Martin Jr
JournalAnnals of surgical oncology (Ann Surg Oncol) Vol. 19 Issue 1 Pg. 131-8 (Jan 2012) ISSN: 1534-4681 [Electronic] United States
PMID21732140 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Antibodies, Monoclonal
  • Antigens, Neoplasm
  • Glycoproteins
  • Iodine Radioisotopes
  • tumor-associated antigen 72
Topics
  • Adenoma (mortality, radionuclide imaging, surgery)
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal
  • Antigens, Neoplasm (immunology)
  • Case-Control Studies
  • Colorectal Neoplasms (mortality, radionuclide imaging, surgery)
  • Female
  • Follow-Up Studies
  • Glycoproteins (immunology)
  • Humans
  • Iodine Radioisotopes
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local (mortality, radionuclide imaging, surgery)
  • Prognosis
  • Prospective Studies
  • Survival Rate

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