Staging System of Minagawa et al for Evaluating a Patient with Liver Metastases from a Colorectal Cancer

Description

Minigawa et al developed a simplified staging system for a patient with liver metastases from a colorectal cancer. This can help identify a patient who may be a candidate for hepatic resection of the metastasis. The authors are from the National Cancer Hospital in Tokyo and the Shinshu University in Matsumoto, Japan.

Parameters:

(1) number of regional lymph nodes with metastatic cancer

(2) serum CEA level at time of hepatic resection

(3) number of liver metastases

(4) number of hepatic lymph nodes with metastases

Parameter	Finding	Points
regional lymph nodes with metastatic cancer	0 to 3	0
	>= 4	1
serum CEA	< 50 ng/mL	0
	>= 50 ng/mL	1
number of liver metastases	1	0
	>= 2	1

number of risk factors present =

= SUM(points for the first 3 parameters)

Number of Hepatic Lymph Nodes with Metastases	Number of Risk Factors	Stage
0	0	1
0	1	2
0	2 or 3	3
>=1	NA	4

where:

• The approximate median survival for Stage 1 is 7-10 years, for Stage 2 is 4 years, for Stage 3 is 2-3 years and for Stage 4 is 1.5 years.

Interpretation:

• Hepatic resection should be offered to a patient with Stage 1, 2 or 3.

• Hepatic resection is inappropriate for a patient with Stage 4.

• Adjuvant chemotherapy was given to a patient with Stage 3 disease.

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Description

Specialty

ICD-10