Annals of Coloproctology

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Ju Yeon Pyo

1 Article

Clinical Impact of Tumor Regression Grade after Preoperative Chemoradiation for Locally Advanced Rectal Cancer: Subset Analyses in Lymph Node Negative Patients: Byung Soh Min, Nam Kyu Kim, Ju Yeon Pyo, Hoguen Kim, Jinsil Seong, Ki Chang Keum, Seung Kook Sohn, Chang Hwan Cho; J Korean Soc Coloproctol. 2011;27(1):31-40. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.31

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10 Citations

Abstract PDF

Background

We investigated the prognostic significance of tumor regression grade (TRG) after preoperative chemoradiation therapy (preop-CRT) for locally advanced rectal cancer especially in the patients without lymph node metastasis.

Methods

One-hundred seventy-eight patients who had cT3/4 tumors were given 5,040 cGy preoperative radiation with 5-fluorouracil/leucovorin chemotherapy. A total mesorectal excision was performed 4-6 weeks after preop-CRT. TRG was defined as follows: grade 1 as no cancer cells remaining; grade 2 as cancer cells outgrown by fibrosis; grade 3 as a minimal presence or absence of regression. The prognostic significance of TRG in comparison with histopathologic staging was analyzed.

Results

Seventeen patients (9.6%) showed TRG1. TRG was found to be significantly associated with cancer-specific survival (CSS; P = 0.001) and local recurrence (P = 0.039) in the univariate study, but not in the multivariate analysis. The ypN stage was the strongest prognostic factor in the multivariate analysis. Subgroup analysis revealed TRG to be an independent prognostic factor for the CSS of ypN0 patients (P = 0.031). TRG had a stronger impact on the CSS of ypN (-) patients (P = 0.002) than on that of ypN (+) patients (P = 0.521). In ypT2N0 and ypT3N0, CSS was better for TRG2 than for TRG3 (P = 0.041, P = 0.048), and in ypN (-) and TRG2 tumors, CSS was better for ypT1-2 than for ypT3-4 (P = 0.034).

Conclusion

TRG was found to be the strongest prognostic factor in patients without lymph node metastasis (ypN0), and different survival was observed according to TRG among patients with a specific histopathologic stage. Thus, TRG may provide an accurate prediction of prognosis and may be used for f tailoring treatment for patients without lymph node metastasis.

Citations

Citations to this article as recorded by

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Prediction of tumor response of rectal cancer cells via 3D cell culture and in�vitro cytotoxicity assay before initiating preoperative chemoradiotherapy
Jeonghyun Kang, Min Park, Jina Kim, Hyuk Hur, Byung Min, Seung Baik, Kang Lee, Nam Kim
Oncology Letters.2019;[Epub] CrossRef
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The prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer
K. I. Abdul‐Jalil, K. M. Sheehan, J. Kehoe, R. Cummins, A. O'Grady, D. A. McNamara, J. Deasy, O. Breathnach, L. Grogan, B. D. P. O'Neill, C. Faul, I. Parker, E. W. Kay, B. T. Hennessy, P. Gillen
Colorectal Disease.2014;[Epub] CrossRef
Pathological grading of regression: an International Study Group perspective
Runjan Chetty, P Gill, Adrian C Bateman, David K Driman, Dhirendra Govender, Andrew R Bateman, Y J Chua, Godman Greywoode, Christine Hemmings, I Imat, Eleanor Jaynes, Cheok Soon Lee, Michael Locketz, Corwyn Rowsell, Anne Rullier, Stefano Serra, Eva Szentg
Journal of Clinical Pathology.2012; 65(10): 865. CrossRef
Pathological grading of regression following neoadjuvant chemoradiation therapy: the clinical need is now: Table 1
Tom P MacGregor, Tim S Maughan, Ricky A Sharma
Journal of Clinical Pathology.2012; 65(10): 867. CrossRef

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