title: Novel clinical staging for patients with end-stage gastrointestinal carcinoma.
abstract: OBJECTIVE
  We created a new clinical staging system for end-stage gastrointestinal (GI) carcinoma to clarify the therapeutic goals for these patients.
  
  
  METHODS
  Data were obtained from a retrospective review of medical charts. Based on daily clinical observation of 144 patients with end-stage GI carcinoma, we classified the terminal stages as A, B, C, and D.
  
  
  RESULTS
  The mean durations of terminal stages A, B, C, and D were 19, 16.6, 6.6, and 1.8 days, respectively, in patients with end-stage gastric cancer and 28.5, 9.1, 5.4, and 1.9 days, respectively, in patients with colorectal cancer. Moreover, 88.0% of patients with gastric carcinoma and 82.6% of patients with colorectal carcinoma passed through terminal stages A, B, C, and D sequentially. The patients in terminal stage B experienced temporary relief of symptoms, but those in terminal stage C did not (P < 0.05).
  
  
  CONCLUSIONS
  These terminal stages can easily be judged by clinical observation and may be an effective new tool with which to manage patients with end-stage GI carcinoma and their families.
authors.affiliation: Department of Surgery, Isesaki Municipal Hospital, 12-1 Tsunatorihonmachi, Isesaki, Gunma 372-0817, Japan.
authors.forename: Naokuni
authors.initials: N
authors.lastname: Yasuda
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.forename: Toru
authors.initials: T
authors.lastname: Ohnaka
authors.forename: Koji
authors.initials: K
authors.lastname: Kamisaka
authors.forename: Akira
authors.initials: A
authors.lastname: Tsunoda
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kusano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D019452:Terminally Ill