大腸癌取扱い規約(英語版) 第2版 Japanese Classification of Colorectal Carcinoma

大腸癌取扱い規約第7版補訂版準拠!英語版第2版刊行!!

編 集 大腸癌研究会
定 価 4,428円
(4,100円+税)
発行日 2009/01/13
ISBN 978-4-307-20244-2

B5判・100頁・図数:60枚・カラー図数:48枚

在庫状況 あり


Thirty-five years have passed since the Japanese Society for Cancer of the Colon and Rectum(JSCCR) was first established in 1973. During this period, the incidence of colorectal cancer has increased 4.5 fold in Japan. Consequently, Japan has one of the highest incidences of colorestal cancer in the world. The first edition of the General Rules of Japanese Classification of Colorectal Carcinoma(JCCRC) was published in Japanese in 1977 and the latest edition(7th edition) in 2006. Our classification system and treatment strategy of colorectal cancer differ in some respects from those of western countries; particularly, in grouping and grading of regional lymph nodes, gradiong of lymph node dissection and management of early cancer. Over a period of 35 years, our treatment strategies have undergone substantial development with advances in diagnostic imaging and an accumulation of experience based on analysis of the database of JSCCR, witch has been reflected in each new edition.
In the 7th Japanese edition, considerable changes have been made to enhance consistency both with TNM classification and with Japanese classifications of other gastrointestinal cancers. In addition, the part relating to treatment strategies has been excluded from the 7th edition as the JSCCR guidelines for the treatment of colorectal cancer were published in 2005. All histopathologic micrographs of various types of tumors have been renewed and macroscopic and colonoscopic photographs of tumors of each macroscopic type have been updated in an attempt to help share uniform pictures of the classification of tumor appearances.
As more than 10 years have passed since the first English edition was translated from the 5th Japanese edition, we have decided to publish the English version of the latest edition. The current edition of JCCRC is intended to clarify for foreign clinicians and pathologists the underlying principles of the current Japanese classification system and how they are being continuously developed upon to further improve quality of diagnosis and prognosis of colorectal cancer.

(by「Preface」)


Guidelines for classification

1 Aims and subjects
 1.1 Aims
 1.2 Subjects

2 General principles

3 Recording of findings
 3.1 Primary tumors
  3.1.1 Number and size of the lesions and proportion of the tumor in relation to the circumference of the bowel
  3.1.2 Tumor location
   3.1.2.1 Definition of large intestine
   3.1.2.2 Anatomical divisions of large intestine
   3.1.2.3 Circumferential divisions of the wall of large intestine
  3.1.3 Macroscopic types
   3.1.3.1 Main macroscopic types
   3.1.3.2 Subtypes pf macroscopic type 0
  3.1.4 Depth of tumor invasion
 3.2 Metastatic lesions
  3.2.1 Lymph node metastasis
   3.2.1.1 Lymph node group and station numbers
   3.2.1.2 Lymph nodes subject to Lymphadenectomy(Regional lymph nodes)
   3.2.1.3 Lymph node metastasis(N)
  3.2.2 Liver metastasis(H)
  3.2.3 Peritoneal metastasis(P)
  3.2.4 Extrahepatic distant metastasis(M)
 3.3 Staging
 3.4 Multicentric colorectal cancers, multiple primary cancers and multiple cancers
 3.5 Family history and hereditary diseases

4 Treatment
 4.1 Endoscopic treatment
 4.2 Surgical treatment
  4.2.1 Approach to the lesion
  4.2.2 Surgical procedures
  4.2.3 Exent of lymph node dissection(D)
  4.2.4 Anastomosis
   4.2.4.1 Types of anastomosis
   4.2.4.2 Methods of anastomosis
  4.2.5 Combined resection of adjacent organs and structures
  4.2.6 Preservation of autonomic nerves(AN)
  4.2.7 Cancer involvment at resection margins
   4.2.7.1 Specimens obtained by endoscopic resection
    4.2.7.1.1 Horizontal margin(lateral/mucosal margin)(HM)
    4.2.7.1.2 Vertical margin(deep/intramural margin)(VM)
   4.2.7.2 Specimens obtained by surgical resection
    4.2.7.2.1 Proximal margin(PM)
    4.2.7.2.2 Distal margin(DM)
    4.2.7.2.3 Radial Margin(circumferential resection margin)(RM)
  4.2.8 Residual tumor(R)
  4.2.9 Curability(Cur)
   4.2.9.1 Endoscopic resection
   4.2.9.2 Surgical resection
 4.3 Chemotherapy and radiotherapy
  4.3.1 Chemotherapy
  4.3.2 Radiotherapy
   4.3.2.1 Aims of radiontherapy
   4.3.2.2 Methods of radiotherapy
    4.3.2.3 Radiation field

5 Handling of resected specimens
 5.1 Macroscopic examination and handling of surgically resected specimens
 5.2 Macroscopic examination ans handling of sndoscopically resected specimens
 5.3 Macroscopic findings
  5.3.1 Tumor locatino
  5.3.2 Macroscopic types
  5.3.3 Serosal and mesenteric invasion
  5.3.4 Lymph node metastasis and location
  5.3.5 Distance from resection and location
  5.3.6 Mode and extent of tumor invasion and metasis
  5.3.7 Tumor size
  5.3.8 Proportion of the tumor relation to circumference of the bowel
  5.3.9 Size of ulcerated area
  5.3.10 Size of the intramucosal component of the tumor
  5.3.11 Protruded tumor
 5.4 Histological Findings
  5.4.1 Histological types
   a Large intestine(excluding vermiform appendix and anal canal)
   b Vermiform appendix
   c Anal canal
  5.4.2 Depth of tumor invasion
  5.4.3 Amount of fibrous stroma
  5.4.4 Invasive growth pattern(INF)
  5.4.5 Invasion of the vessels
   5.4.5.1 Lymphatic invasion(ly)
   5.4.5.2 Vanous invasion(v)
  5.4.6 Lymph node metastasis
 5.5 Histological criteria for assessment of response to neoadjuvant therapy
 5.6 Histological assessment of biopsy specimens(Group classification)

6 Outcome survey
 6.1 Number of patients
 6.2 Multicentric colorectal cansers, multiple primary cancers and multiple cancers
 6.3 Modalities of teratment and adjuvant therapy
 6.4 Total number of patients who had any treatment for colorectal cancers
  6.4.1 Resection rate
  6.4.2 Endoscopic treatment
  6.4.3 Chemotherapy and radiotherapy
 6.5 Number and rate of operative mortality
 6.6 Number and rate of hospital mortality following surgery
 6.7 Follow-up survey
  6.7.1 Survival
  6.7.2 Recurrence/Metastasis; site(s) and mode
 6.8 Long-term outcome
 6.9 Assessment of response to chemotherapy and radiotherapy

Supplment; TNM Classification


Explanatory notes

2 General principles
3 Recording of findings
 3.1 Primary tumors
  3.1.1 Number and size of the lesions and proportioin of the tumor in relation to the circumference of the bowel
  3.1.2 Tumor location
   3.1.2.2 Anatomical divisions of the colon, rectum and anus
  3.1.3 Macroscopic types
  3.1.4 Depth of tumor invasion
 3.2 Metastatic lesions
  3.2.1 Lymph node metastasis
   3.2.1.1 Lymph node groups and station numbers
   3.2.1.2 Lymph nodes subject to lymphadenectomy(Regional lymph nodes)
    3.2.1.2.1 Station number cording
    3.2.1.2.2 Lymph node grouping
    3.2.1.2.3 Pericolic lymph nodes
    3.2.1.2.4 Perirectal lymph nodes
   3.2.1.3 Lymph node metastasis(N)
  3.2.2 Liver metastasis(H)
  3.2.3 Peritoneal metastasis(P)
 3.3 Staging
 3.4 Multicentric colorectal cancers, multiple primary cancers and multiple cancers
 3.5 Family history and herediatry diseases
  3.5.1 Familial adenomatous polyposis(FAP)
  3.5.2 Hereditary non-polyposis colorectal cancer(HNPCC)

4 Treatment
 4.2 Surgical teratment
  4.2.2 Surgical procedures
  4.2.6 Preservation of autonomic nerves
  4.2.8 Residual tumor status(R)
 4.3 Chemotherapy and radiotherapy
  4.3.1 Chemotherapy
   4.3.1.1 Definition of lesions for evaluation
    4.3.1.1.1 Measurable lesions
    4.3.1.1.2 Non-measurable criteria
   4.3.1.2 Selection of target/non-target lesions and baseline documentation
   4.3.1.3 Assessment of tumor response
   4.3.1.4 Tumor response criteria
    4.3.1.4.1 Response criteria for target lesions
    4.3.1.4.2 Response criteria for non-target lesions
    4.3.1.4.3 Overall response
    4.3.1.4.4 Best overall response : confirmation requied
   4.3.1.5 Response rate
   4.3.1.6 Overall survival(OS), Progression-free survival(PFS), Relapse-free survival(RFS), Disease-free survival(DFS), Time to teratment failure(TTF)
   4.3.1.7 Adverse events(CTC-AE)

5 Handling of resected specimens
 5.6 Histological assessment of biopsy specimens(Group classification)
  5.6.1 Principles
  5.6.2 Criteria for grouping


Histological Photographs