TABLE 4.

Variant 4: Initial treatment of a 74-year-old female with history of coronary artery disease, severe emphysema, diabetes, now with an asymptomatic nonobstructing uT3N0 rectal primary cancer with extensive hepatic metastases and abdominal carcinomatosis. Poor oral intake. KPS 50

Treatment	Rating*	Comments
Best supportive care	8
Systemic biological or chemotherapy	2
Resection of rectal primary	1
Preoperative pelvic RT + concurrent 5-FU-based chemotherapy	1
Resection of metastatic disease	1

^*Rating scale: 1–3, usually not appropriate; 4–6, may be appropriate; 7–9, usually appropriate.