Table 1. Definitions of PRETEXT and POSTTEXT Groups and Annotation Factorsa

PRETEXT and POSTTEXT GroupsDefinitionImage
IOne section involved; three adjoining sections are tumor free.
Liver PRETEXT I; drawing shows two livers. Dotted lines divide each liver into four vertical sections of about the same size. In the first liver, cancer is shown in the section on the far left. In the second liver, cancer is shown in the section on the far right.
IIOne or two sections involved; two adjoining sections are tumor free.
Liver PRETEXT II; drawing shows five livers. Dotted lines divide each liver into four vertical sections that are about the same size. In the first liver, cancer is shown in the two sections on the left. In the second liver, cancer is shown in the two sections on the right. In the third liver, cancer is shown in the far left and far right sections. In the fourth liver, cancer is shown in the second section from the left. In the fifth liver, cancer is shown in the second section from the right.
IIITwo or three sections involved; one adjoining section is tumor free.
Liver PRETEXT III; drawing shows seven livers. Dotted lines divide each liver into four vertical sections that are about the same size. In the first liver, cancer is shown in three sections on the left. In the second liver, cancer is shown in the two sections on the left and the section on the far right. In the third liver, cancer is shown in the section on the far left and the two sections on the right. In the fourth liver, cancer is shown in three sections on the right. In the fifth liver, cancer is shown in the two middle sections. In the sixth liver, cancer is shown in the section on the far left and the second section from the right. In the seventh liver, cancer is shown in the section on the far right and the second section from the left.
IVFour sections involved.
Liver PRETEXT IV; drawing shows two livers. Dotted lines divide each liver into four vertical sections that are about the same size. In the first liver, cancer is shown across all four sections. In the second liver, cancer is shown in the two sections on the left and spots of cancer are shown in the two sections on the right.
Annotation Factors
VVenous involvement: Vascular involvement of the retrohepatic vena cava or involvement of all three major hepatic veins (right, middle, and left).
V0—Tumor within 1 cm.
V1—Tumor touching.
V2—Tumor compressing or distorting.
V3—Tumor ingrowth, encasement, or thrombus.
PPortal involvement: Vascular involvement of the main portal vein and/or both right and left portal veins.
P0—Tumor within 1 cm.
P1—Tumor touching.
P2—Tumor compressing or distorting.
P3 —Tumor ingrowth, encasement, or thrombus.
EExtrahepatic involvement of a contiguous structure such as the diaphragm, abdominal wall, stomach, colon, etc.
E1—Direct extension of tumor in adjacent organs or diaphragm.
E2—Peritoneal nodules (add a suffix to E if any tumor ascites).
MDistant metastatic disease (usually lungs, occasionally bone or brain).
CCaudate lobe involvement.
C1—Tumor involving the caudate lobe (all C1 patients are at least PRETEXT II).
FMultifocal tumor nodules.
F1—Two or more discrete tumors (multifocal).
NLymph node involvement.
N1—Abdominal lymph node metastasis only.
N2—Extra-abdominal lymph node metastasis (with or without abdominal nodes).
RTumor rupture.
H1Imaging and clinical findings of intraperitoneal hemorrhage.
M1Any metastasis other than E or N.

aAdapted from Roebuck et al.[3]

From: Childhood Liver Cancer Treatment (PDQ®)

Cover of PDQ Cancer Information Summaries
PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
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