Validation and Modification of the Japanese Classification System for Liver Metastases from Colorectal Cancer: A Multi-institutional Study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-03-11

AUTHORS

Eiji Shinto, Keiichi Takahashi, Tatsuro Yamaguchi, Yojiro Hashiguchi, Kenjiro Kotake, Michio Itabashi, Masamichi Yasuno, Yukihide Kanemitsu, Genichi Nishimura, Yoshito Akagi, Toshihiko Sato, Tomoyuki Kato, Hiroshi Matsumoto, Kazuo Hase, Kenichi Sugihara, Study Group for Liver Metastasis projected by the Japanese Society for Cancer of the Colon and Rectum (JSCCR)

ABSTRACT

BackgroundA Japanese multicenter study disclosed four prognostic indicators of colorectal cancer liver metastases: ≥5 hepatic tumors (HT), HT size > 5 cm, nodal status (N2) of primary cancer, and the presence of extrahepatic metastases (EM). The Japanese classification was then defined as Stage A, HT1 (≤4 lesions and ≤5 cm) and N0/1; Stage B, HT2 (≥5 lesions or >5 cm) and N0/1, or HT1 and N2; and Stage C, HT2 and N2, HT3 (≥5 lesions and >5 cm) with any N, or EM1 (presence of EM) with any HT/N. This study aimed to validate the prognostic reliability in a recent population and to develop a modified staging system that divided Stage C patients.MethodsA total of 1185 patients diagnosed with liver metastases between 2007 and 2008 were enrolled in the study. According to the classification, 358, 257, and 570 patients were categorized as Stages A, B, and C, respectively. Stage C was further divided into two groups: Stage C-I, HT3 and N0/1, HT2 and N2, or HT1 and EM1; and Stage C-II, HT3 and N2, or HT2/3 and EM1.ResultsCumulative overall survival curves for Stages A, B, and C were significantly different between each two stages (p < 0.0001, p < 0.0001). The modified system discriminated patients with a relatively better outcome (Stage C-I) from desperate patients (Stage C-II) (p < 0.0001).ConclusionsThe Japanese classification system was adequately validated in a recent population, and the modified system is useful in risk stratification of Stage C cases. More... »

PAGES

3888-3895

References to SciGraph publications

Journal

TITLE

Annals of Surgical Oncology

ISSUE

12

VOLUME

22

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-015-4470-y

DOI

http://dx.doi.org/10.1245/s10434-015-4470-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1017148520

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25758188


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25 schema:description BackgroundA Japanese multicenter study disclosed four prognostic indicators of colorectal cancer liver metastases: ≥5 hepatic tumors (HT), HT size > 5 cm, nodal status (N2) of primary cancer, and the presence of extrahepatic metastases (EM). The Japanese classification was then defined as Stage A, HT1 (≤4 lesions and ≤5 cm) and N0/1; Stage B, HT2 (≥5 lesions or >5 cm) and N0/1, or HT1 and N2; and Stage C, HT2 and N2, HT3 (≥5 lesions and >5 cm) with any N, or EM1 (presence of EM) with any HT/N. This study aimed to validate the prognostic reliability in a recent population and to develop a modified staging system that divided Stage C patients.MethodsA total of 1185 patients diagnosed with liver metastases between 2007 and 2008 were enrolled in the study. According to the classification, 358, 257, and 570 patients were categorized as Stages A, B, and C, respectively. Stage C was further divided into two groups: Stage C-I, HT3 and N0/1, HT2 and N2, or HT1 and EM1; and Stage C-II, HT3 and N2, or HT2/3 and EM1.ResultsCumulative overall survival curves for Stages A, B, and C were significantly different between each two stages (p < 0.0001, p < 0.0001). The modified system discriminated patients with a relatively better outcome (Stage C-I) from desperate patients (Stage C-II) (p < 0.0001).ConclusionsThe Japanese classification system was adequately validated in a recent population, and the modified system is useful in risk stratification of Stage C cases.
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32 schema:keywords BackgroundA Japanese multicenter study
33 C cases
34 C patients
35 ConclusionsThe Japanese classification system
36 EM1
37 HT size
38 HT/N.
39 HT1
40 HT2
41 HT3
42 Japanese classification
43 Japanese classification system
44 Japanese multicenter study
45 N0/1
46 N2
47 better outcomes
48 cancer
49 cancer liver metastases
50 cases
51 classification
52 classification system
53 colorectal cancer
54 colorectal cancer liver metastases
55 curves
56 desperate patients
57 extrahepatic metastases
58 group
59 hepatic tumors
60 indicators
61 liver metastases
62 metastasis
63 modification
64 modified system
65 multi-institutional study
66 multicenter study
67 n.
68 nodal status
69 outcomes
70 overall survival curves
71 patients
72 population
73 presence
74 primary cancer
75 prognostic indicator
76 prognostic reliability
77 recent population
78 reliability
79 risk stratification
80 size
81 stage
82 stage A
83 stage B
84 stage C
85 stage C cases
86 stage C patients
87 staging system
88 status
89 stratification
90 study
91 survival curves
92 system
93 total
94 tumors
95 validation
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