The Necessity for Staging Liver Metastases and Standardizing Treatment-Response Criteria. The Case of Secondaries of Colo-Rectal Origin

Pettavel, J; Leyvraz, Serge; Douglas, P. S.

doi:10.1007/978-94-009-6051-0_15

Cited by 23 publications

(3 citation statements)

References 10 publications

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“…Practically all of them incorporated extent of hepatic tumor replacement as a major correlate to survival. Two specifically incorporated AP as part of the staging criteria for patients with colorectal liver metastases [26,27].…”

Section: Table IV Review Of Prognostic Factors In Patients With Colomentioning

confidence: 99%

Determinants of survival in patients with unresectable colorectal liver metastases

Chang

Steinberg

Culnane

et al. 1989

Journal of Surgical Oncology

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Prognostic indicators in 67 patients with unresectable colorectal liver metastases were analyzed. These patients were identified to have isolated hepatic metastases after extensive radiological evaluation and demonstrated good performance status without evidence of liver failure. Univariate analysis revealed 6 of 22 factors that were associated with survival: alkaline phosphatase (AP), lactic dehydrogenase (LDH), occult intra-abdominal extrahepatic disease, percent hepatic replacement by tumor (PHR), sex, and carcinoembryonic antigen (CEA). A multivariate analysis identified two independent factors that jointly influenced survival: AP and PHR. Patients with an AP greater than 175 U/liter had a greater than threefold relative risk of dying compared with patients with AP less than or equal to 175 U/liter (P = 0.0001). Patients with PHR II or III (25-75%, greater than 75%) also had a greater than threefold relative risk of dying compared with patients with PHR 1 (less than 25%; P = 0.0074). Our patient population is typical of that being entered into trials examining experimental therapies. Alkaline phosphatase and extent of liver involvement by tumor are significant prognostic indicators that should be accounted for in such studies.

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Section: Table IV Review Of Prognostic Factors In Patients With Colomentioning

confidence: 99%

Determinants of survival in patients with unresectable colorectal liver metastases

Chang

Steinberg

Culnane

et al. 1989

Journal of Surgical Oncology

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“…Patients classified as PS 4 were excluded from the study. Patients having only liver métastases were divided into three groups according to the criteria for the percentage of hepatic in vasion (P ill) described by Pettavcl et al [13]: PHI I, <25% : PHI 2, 25 75%; PHI 3, >75% . Patients with only lung or abdominal métastasés were divided into two groups (métastasés 'yes' or 'no'), since there arc still no universally accepted clinical subdivisions.…”

Section: Methodsmentioning

confidence: 99%

Advanced Colon Cancer: Staging and Prognosis by CEA Test

et al. 1990

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The carcinoembryonic antigen (CEA) test was studied in 54 patients with advanced stages of colon cancer which was treated with high doses of folinic acid + fluorouracil. The CEA test correlates evaluated included: prognostic value, performance status, metastatic pattern, histologic grading, predictive value for response to chemotherapy, and value differences in cases with partial response to therapy. CEA levels <5 ng/ml corresponded to a greater survival time than did levels >5 ng/ml. A correlation of CEA with performance status and with metastatic pattern was demonstrated. A progressive increase in average CEA values corresponded to increases in neoplastic mass. Although CEA levels were not found to be an index for predicting the response to chemotherapy, there was a significant difference between pre- and posttreatment levels for partial response. The results suggest that CEA offers an additional criterion for evaluating the response of colon cancer to chemotherapy and it also has a role in the staging of advanced disease.

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“…Gennari et al's system [ 12] has already been referred to. A simpler system in common use is the Luzanne system designed by Pettavel et al [32], This is basically a percentage hepatic re placement system with three stages defined as less than 25%, 25-75%, and greater than 75% replacement with tumour. In the Inter national Staging System proposed by Sugarbaker et al [31], in addition to these stages (P1-P3) three further features would be doc umented: those with potentially curative re sections, those with cxtrahepatic disease (E), and those with symptoms (S).…”

Section: Stagingmentioning

confidence: 99%