Clinical-pathologic staging of large-bowel cancer. A report of the ASCRS Committee.

After surgical treatment in patients with large-bowel cancer, a prediction about the likelihood for cure remains uncertain despite the availability of several different types of staging systems. A committee of the American Society of Colon and Rectal Surgeons has reviewed the available data and concludes that future assessments of prognosis should be based on a combination of clinical and pathologic prognostic factors, using multivariate statistical techniques for the analysis. Although many important prognostic factors are known, there is much to learn about these and other items before a confident prediction of long-term outcome can be made. An extension of these methods should be possible to assist in prospective clinical decision-making based on clinical and investigational data. Such a system would be of particular value for patients with rectal cancer for whom cost-benefit relationships of alternative treatments can be so controversial. It is concluded that an accepted, standard nomenclature is required to reach both these objectives using large multicenter studies.