Automatic preoperative classification of carcinoma of the colon and rectum

The Dukes' and TNM systems for staging carcinoma of the colon and rectum are still the best pathologic classifications, but they do not apply to all patients and do not distinguish between patients who will die and patients who will be cured by the same therapeutic procedure. A new approach to this problem should be to establish a biochemical automatic classification, complementary to the morphologic one, which allow us to classify every patient before and after the first and subsequent treatments. By using several nonspecific tumor markers, such as CEA, AAT, AF, AAG, GGT and transferrine, a discriminant analysis was executed among the groups of patients with LD, RD and DD. Our initial results with only 12.8 per cent of incorrect classifications, that is patients classified in a less advanced group, suggest that this system may be quite useful in order to select those patients with carcinoma of the rectum who should benefit from preoperative radiotherapy as well as those who should receive adjuvant therapy after the first treatment. On the other hand, for patients classified in a more advanced group than the pathologic grading, we may well be able to identify those patients with occult disease for which the frequency of revisions should be shorter.