Figure 4

Proposed treatment strategy according to the A) Tokuhashi and B) Tomita score systems. Tokuhashi scores of 10–11 were reclassified to recommend excisional surgery (either en bloc or intralesional resection) instead of palliative surgery (oblique lines). A Tomita score of 8 and Tokuhashi scores of 10–11 have been reclassified to recommend palliative surgery instead of conservative treatment (oblique lines).