Urgent need for a new staging system in advanced colorectal cancer

Graeme J. Poston, Joan Figueras, Felice Giuliante, Gennaro Nuzzo, Alberto F. Sobrero, Jean Francois Gigot, Bernard Nordlinger, Rene Adam, Thomas Gruenberger, Michael A. Choti, Anton J. Bilchik, Eric J D Van Cutsem, Jy Ming Chiang, Michael I. D'Angelica

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Despite recent advances in the medical treatment of metastatic colorectal cancer (mCRC), which include irinotecan- and oxaliplatin-based first-line regimens, the concept of planned sequential therapy involving three active agents during the course of a patient's treatment and the increasing use of targeted monoclonal antibodies, 5-year survival rates for patients with advanced CRC remain unacceptably low. For patients with CRC liver metastases, liver resection remains the only chance of cure, with 5-year survival rates ranging from 25% to 40%. However, 80% to 85% of patients with stage IV CRC have liver disease which is considered unresectable at presentation. The rapid expansion in the use of improved combination chemotherapy regimens plus or minus biologics, to render initially unresectable metastases resectable has increased the percentage of patients eligible for potentially curative surgery. However, the current staging criteria for CRC patients with metastatic disease do not reflect these recent changes or the fact that there is also a large variation in the survival of patients with stage IV CRC. For example the survival for a patient with a solitary, resectable liver metastasis is better than that for a patient with stage III disease. A new staging system is therefore needed that acknowledges both the improvements that have been made in surgical techniques for resectable metastases and the impact of modern chemotherapy on rendering initially unresectable CRC liver metastases resectable, while at the same time distinguishing between patients with a chance of cure at presentation and those for whom only palliative treatment is possible.

Original languageEnglish (US)
Pages (from-to)4828-4833
Number of pages6
JournalJournal of Clinical Oncology
Volume26
Issue number29
DOIs
StatePublished - Oct 10 2008

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Colorectal Neoplasms
Neoplasm Metastasis
oxaliplatin
irinotecan
Liver
Survival Rate
Survival
Combination Drug Therapy
Biological Products
Palliative Care
Liver Diseases
Therapeutics
Monoclonal Antibodies
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Poston, G. J., Figueras, J., Giuliante, F., Nuzzo, G., Sobrero, A. F., Gigot, J. F., ... D'Angelica, M. I. (2008). Urgent need for a new staging system in advanced colorectal cancer. Journal of Clinical Oncology, 26(29), 4828-4833. https://doi.org/10.1200/JCO.2008.17.6453

Urgent need for a new staging system in advanced colorectal cancer. / Poston, Graeme J.; Figueras, Joan; Giuliante, Felice; Nuzzo, Gennaro; Sobrero, Alberto F.; Gigot, Jean Francois; Nordlinger, Bernard; Adam, Rene; Gruenberger, Thomas; Choti, Michael A.; Bilchik, Anton J.; Van Cutsem, Eric J D; Chiang, Jy Ming; D'Angelica, Michael I.

In: Journal of Clinical Oncology, Vol. 26, No. 29, 10.10.2008, p. 4828-4833.

Research output: Contribution to journalArticle

Poston, GJ, Figueras, J, Giuliante, F, Nuzzo, G, Sobrero, AF, Gigot, JF, Nordlinger, B, Adam, R, Gruenberger, T, Choti, MA, Bilchik, AJ, Van Cutsem, EJD, Chiang, JM & D'Angelica, MI 2008, 'Urgent need for a new staging system in advanced colorectal cancer', Journal of Clinical Oncology, vol. 26, no. 29, pp. 4828-4833. https://doi.org/10.1200/JCO.2008.17.6453
Poston GJ, Figueras J, Giuliante F, Nuzzo G, Sobrero AF, Gigot JF et al. Urgent need for a new staging system in advanced colorectal cancer. Journal of Clinical Oncology. 2008 Oct 10;26(29):4828-4833. https://doi.org/10.1200/JCO.2008.17.6453
Poston, Graeme J. ; Figueras, Joan ; Giuliante, Felice ; Nuzzo, Gennaro ; Sobrero, Alberto F. ; Gigot, Jean Francois ; Nordlinger, Bernard ; Adam, Rene ; Gruenberger, Thomas ; Choti, Michael A. ; Bilchik, Anton J. ; Van Cutsem, Eric J D ; Chiang, Jy Ming ; D'Angelica, Michael I. / Urgent need for a new staging system in advanced colorectal cancer. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 29. pp. 4828-4833.
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