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Simplified Staging System for Predicting the Prognosis of Patients With Resectable Liver Metastasis—Invited Critique
John F. Gibbs, MD
Arch Surg. 2007;142(3):277.
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Options for patients with hepatic colorectal metastases have increased with improvements in surgical technique, better intrahepatic and extrahepatic staging, and perioperative supportive care. As a result, we have entered a crossroads in selecting the appropriate therapeutic modality to address these patients. Recognizing that 60% of the approximately 140 000 patients with colorectal cancer encountered yearly in the United States will develop hepatic metastases, there has been a growing tendency to extend the boundaries of surgical-directed treatment by means of resection, hepatic arterial infusion pumps, or ablation.
Evidence-based medicine mandates that we consider outcomes based on our understanding of tumor biology. Since the 1986 publication of the hepatic tumor registry by Hughes et al,1 many investigators have attempted to create a reproducible surgical selection schema based on patient- and tumor-related characteristics. The article by Minagawa and colleagues draws into question the appropriateness of extending the boundaries of hepatic . . . [Full Text of this Article]
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RELATED ARTICLE
Simplified Staging System for Predicting the Prognosis of Patients With Resectable Liver Metastasis: Development and Validation
Masami Minagawa, Junji Yamamoto, Tomoo Kosuge, Yutaka Matsuyama, Shin-ichi Miyagawa, and Masatoshi Makuuchi
Arch Surg. 2007;142(3):269-276.
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