Colorectal Cancer
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 21, 2006; 12(43): 6961-6965
Published online Nov 21, 2006. doi: 10.3748/wjg.v12.i43.6961
Proposal of a new and simple staging system of colorectal liver metastasis
Ikuo Nagashima, Tadahiro Takada, Hirokazu Nagawa, Tetsuichiro Muto, Kota Okinaga
Ikuo Nagashima, Tadahiro Takada, Okinaga, Department of Surgery, Teikyo University, School of Medicine, Tokyo, Japan
Hirokazu Nagawa, Tetsuichiro Muto, Department of Surgical Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Ikuo Nagashima, MD, Department of Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo 173-8605, Japan. inaga@med.teikyo-u.ac.jp
Telephone: +81-3-3964-1231 Fax: +81-3-5375-6097
Received: July 17, 2006
Revised: July 25, 2006
Accepted: August 3, 2006
Published online: November 21, 2006
Abstract

AIM: To create a new, simple and useful staging system for colorectal liver metastasis analogous to the Tumor Node Metastasis classification system of International Union Against Cancer.

METHODS: A retrospective review was undertaken of 81 consecutive patients who underwent partial hepatectomy for colorectal liver metastases (group 1). Clinical and pathological features of both primary and metastatic liver cancers were entered into a multivariate analysis to determine independent variables helpful in accurately predicting long-term prognosis after hepatectomy. Using selected variables, we created a new staging system like TNM classification. The usefulness of the new staging system was examined in a series of 92 patients from another hospital (group 2).

RESULTS: Multivariate analysis showed that 81 patients in group 1 had significant multiple hepatic tumors with the largest tumor being more than 5 cm in diameter, resectable extrahepatic distant metastases, and independent prognostic factors for poor survival after hepatectomy. Using these three variables, we created a new staging system to classify patients with colorectal liver metastases. Finally, our new staging system classified the patients both in group 1 and in group 2.

CONCLUSION: Our new staging system of colorectal liver metastasis is simple and useful for staging patients.

Keywords: Colorectal liver metastasis; Staging system; Prognostic factor