Tumor regression grades: can they influence rectal cancer therapy decision tree?

IF 1.6 Q4 ONCOLOGY
International Journal of Surgical Oncology Pub Date : 2013-01-01 Epub Date: 2013-09-25 DOI:10.1155/2013/572149
Marisa D Santos, Cristina Silva, Anabela Rocha, Eduarda Matos, Carlos Nogueira, Carlos Lopes
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引用次数: 21

Abstract

Background: Evaluating impact of tumor regression grade in prognosis of patients with locally advanced rectal cancer (LARC).

Materials and methods: We identified from our colorectal cancer database 168 patients with LARC who received neoadjuvant therapy followed by complete mesorectum excision surgery between 2003 and 2011: 157 received 5-FU-based chemoradiation (CRT) and 11 short course RT. We excluded 29 patients, the remaining 139 were reassessed for disease recurrence and survival; the slides of surgical specimens were reviewed and classified according to Mandard tumor regression grades (TRG). We compared patients with good response (Mandard TRG1 or TRG2) versus patients with bad response (Mandard TRG3, TRG4, or TRG5). Outcomes evaluated were 5-year overall survival (OS), disease-free survival (DFS), local, distant and mixed recurrence.

Results: Mean age was 64.2 years, and median followup was 56 months. No statistically significant survival difference was found when comparing patients with Mandard TRG1 versus Mandard TRG2 (p = .77). Mandard good responders (TRG1 + 2) have significantly better OS and DFS than Mandard bad responders (TRG3 + 4 + 5) (OS p = .013; DFS p = .007).

Conclusions: Mandard good responders had a favorable prognosis. Tumor response (TRG) to neoadjuvant chemoradiation should be taken into account when defining the optimal adjuvant chemotherapy regimen for patients with LARC.

Abstract Image

Abstract Image

肿瘤消退等级:能否影响直肠癌治疗决策树?
背景:评价肿瘤消退等级对局部晚期直肠癌(LARC)患者预后的影响。材料和方法:我们从我们的结直肠癌数据库中确定了168例LARC患者,他们在2003年至2011年期间接受了新辅助治疗并进行了完整的肠系膜切除手术:157例接受了基于5- fu的放化疗(CRT)和11例短期放疗。我们排除了29例患者,其余139例重新评估疾病复发和生存;根据标准肿瘤消退分级(TRG)对手术标本的载玻片进行回顾和分类。我们比较了反应良好的患者(标准TRG1或TRG2)和反应不良的患者(标准TRG3、TRG4或TRG5)。评估的结果包括5年总生存期(OS)、无病生存期(DFS)、局部、远处和混合性复发。结果:平均年龄64.2岁,中位随访56个月。与标准TRG1组相比,标准TRG2组患者的生存期无统计学差异(p = 0.77)。标准良好应答者(TRG1 + 2)的OS和DFS明显优于标准不良应答者(TRG3 + 4 + 5) (OS p = 0.013;DFS p = .007)。结论:良好应答者预后良好。在确定LARC患者的最佳辅助化疗方案时,应考虑肿瘤对新辅助放化疗的反应(TRG)。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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