Colorectal adenocarcinoma
Item
histologically proven diagnosis of colorectal adenocarcinoma
boolean
C1319315 (UMLS CUI [1])
Liver metastases
Item
metastatic disease present in the liver only.
boolean
C0494165 (UMLS CUI [1])
Chest, abdomen, pelvis CT
Item
absence of extrahepatic metastases excluded by ct chest, abdomen and pelvis. indeterminate ct findings may require verification by fdg-pet scanning.
boolean
C0202823 (UMLS CUI [1])
C0412620 (UMLS CUI [2])
C0412628 (UMLS CUI [3])
Unresectable liver metastases
Item
liver-only metastases determined to be unresectable at presentation on a pre-treatment liver mri with an appropriate liver specific contrast (eg. tesla) by a specialist multidisciplinary team (consisting of medical oncologist, hepatic surgeon and radiologist). guidelines for determining unresectability include:
boolean
C1519810 (UMLS CUI [1,1])
C0494165 (UMLS CUI [1,2])
Number of metastases
Item
presence of >4 metastases;
boolean
C0449788 (UMLS CUI [1,1])
C0027627 (UMLS CUI [1,2])
Size of metastases
Item
size >5cm;
boolean
C1300989 (UMLS CUI [1])
Location and distribution of metastatic disease
Item
location and distribution of metastatic disease within the liver unsuitable for resection with clear margins (eg. involvement of both lobes of liver; invasion of intrahepatic vascular structures);
boolean
C1515974 (UMLS CUI [1,1])
C0027627 (UMLS CUI [1,2])
C1704711 (UMLS CUI [2,1])
C0027627 (UMLS CUI [2,2])
Extent of liver involvement
Item
extent of liver involvement precluding resection with adequate post-resection residual liver parenchyma volume for viable liver function in the immediate post-operative period;
boolean
C0439792 (UMLS CUI [1,1])
C0449625 (UMLS CUI [1,2])
Liver vascular flow
Item
inability to retain adequate vascular in flow and out flow to maintain viable liver function.
boolean
C0232338 (UMLS CUI [1,1])
C0023884 (UMLS CUI [1,2])
Prior therapy for metastatic colorectal cancer
Item
no previous treatment for metastatic colorectal cancer, including chemotherapy, targeted or experimental therapies (e.g. anti-vegf or anti-egfr), radiotherapy to the liver, or surgery or radiofrequency ablation to liver metastases.
boolean
C1514463 (UMLS CUI [1,1])
C0948380 (UMLS CUI [1,2])
Operable with curative intent
Item
feasibility of surgery with curative intent:
boolean
C0205188 (UMLS CUI [1,1])
C1276305 (UMLS CUI [1,2])
Resectable primary tumor
Item
if the primary colorectal tumour is in situ, the primary tumour must also be resectable with curative intent
boolean
C1514888 (UMLS CUI [1,1])
C0677930 (UMLS CUI [1,2])
Relapse
Item
patients presenting with liver metastases only relapse after initially curative resection of their primary colorectal cancer followed by treatment with adjuvant chemotherapy may not be entered into the study if the relapse has occurred within 12 months of completion of adjuvant treatment
boolean
C0277556 (UMLS CUI [1])
Health status
Item
adequate medical fitness to undergo neoadjuvant treatment and surgery with curative intent (hepatectomy +/- resection of primary tumour, if required)
boolean
C0018759 (UMLS CUI [1])
Liver function
Item
absence of pre-existing liver dysfunction of childs pugh grade b or greater. patients who are suspected of having pre-existing liver dysfunction due to clinical, biochemical or radiological findings, should have significant liver disease excluded by a liver biopsy prior to study entry.
boolean
C0232741 (UMLS CUI [1])