Staging of advanced colorectal cancer.
The management of advanced colorectal cancer has changed dramatically during the last decade. By redefining resectability, and with the use of modern chemotherapy, nearly 10% of unresectable patients are now alive 5 years after diagnosis, and, overall, 20% are alive at 5 years when the combined results of surgery and chemotherapy are considered. These achievements are not reflected in the current staging, which categorizes all disease spread beyond the lymph node basin of the primary tumor as unstratified stage 4. This article discusses the merits of a number of proposals for a new, meaningful staging system for advanced colorectal cancer.
Poston
Graeme J
GJ
Division of Digestive Diseases, Critical Care and Anesthesia, Center for Digestive Diseases, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK. graeme.poston@aintree.nhs.uk
D015179:Colorectal Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D018450:Disease Progression; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome