Yizhou Huang, Maohui Chen, Yuanpu Wei, Bingqiang Cai, Yongcong Zhang, Chuanquan Lin, Shuliang Zhang, Taidui Zeng, Chun Chen, Bin Zheng
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This study aimed to explore the role of TRG and other clinical characteristics in predicting the efficacy of postoperative adjuvant therapy in ESCC patients receiving neoadjuvant therapy.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study included patients who underwent R0 esophagectomy for thoracic ESCC after neoadjuvant therapy between January 2016 and December 2021 across three high-volume centers. Patients were assessed by TRG and divided into good responders (TRG 0–1) and poor responders (TRG 2–3).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 416 patients with a median follow-up of 52 months, adjuvant therapy extended median survival by 8 months, which was statistically insignificant (<i>p</i> = 0.28). In the TRG 0–1 subgroup, those receiving adjuvant therapy had 3-year and 5-year OS rates of 94.6% and 86.8%, compared to 78.8% and 71.6% for the observation group (<i>p</i> = 0.02). Multivariable Cox regression showed adjuvant therapy was associated with reduced mortality in the TRG 0–1 (HR 0.32; 95% CI 0.14–0.73; <i>p</i> = 0.006), positive lymph nodes (HR 0.53; 95% CI 0.36–0.78; <i>p</i> = 0.001), and ypT3-4 subgroups (HR 0.63; 95% CI 0.43–0.92; <i>p</i> = 0.017).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>TRG is a promising predictor of the prognostic value of adjuvant therapy in ESCC patients. 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Tumor regression grade (TRG) reflects the response to neoadjuvant therapy and may predict patient prognosis, yet its role in guiding adjuvant therapy remains unexplored. This study aimed to explore the role of TRG and other clinical characteristics in predicting the efficacy of postoperative adjuvant therapy in ESCC patients receiving neoadjuvant therapy.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This study included patients who underwent R0 esophagectomy for thoracic ESCC after neoadjuvant therapy between January 2016 and December 2021 across three high-volume centers. Patients were assessed by TRG and divided into good responders (TRG 0–1) and poor responders (TRG 2–3).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among 416 patients with a median follow-up of 52 months, adjuvant therapy extended median survival by 8 months, which was statistically insignificant (<i>p</i> = 0.28). 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引用次数: 0
摘要
背景：对于局部晚期食管鳞状细胞癌（ESCC），手术后新辅助治疗是首选，但辅助治疗的必要性仍存在争议。肿瘤消退等级（Tumor regression grade， TRG）反映了对新辅助治疗的反应，可以预测患者的预后，但其在指导辅助治疗中的作用尚不明确。本研究旨在探讨TRG等临床特征对ESCC患者接受新辅助治疗后辅助治疗效果的预测作用。该研究纳入了2016年1月至2021年12月期间在三个大容量中心接受新辅助治疗后接受R0食管切除术的胸部ESCC患者。采用TRG对患者进行评估，分为良好反应者（TRG 0-1）和不良反应者（TRG 2-3）。结果416例患者中位随访52个月，辅助治疗使中位生存期延长8个月，差异无统计学意义（p = 0.28）。在TRG 0-1亚组中，接受辅助治疗的3年和5年OS分别为94.6%和86.8%，而观察组为78.8%和71.6% （p = 0.02）。多变量Cox回归显示，辅助治疗与TRG 0-1亚组（HR 0.32; 95% CI 0.14-0.73; p = 0.006）、淋巴结阳性（HR 0.53; 95% CI 0.36-0.78; p = 0.001）和ypT3-4亚组（HR 0.63; 95% CI 0.43-0.92; p = 0.017）的死亡率降低相关。结论TRG是预测ESCC患者辅助治疗预后的良好指标。TRG反应良好、淋巴结阳性和ypT3-4期的患者可从辅助治疗中获益。
Tumor Regression Grade as a Predictor of Adjuvant Therapy Benefits in Esophageal Squamous Cell Carcinoma Patients After Neoadjuvant Therapy
Background
Neoadjuvant therapy followed by surgery is preferred for locally advanced esophageal squamous cell carcinoma (ESCC), but the necessity of adjuvant therapy remains controversial. Tumor regression grade (TRG) reflects the response to neoadjuvant therapy and may predict patient prognosis, yet its role in guiding adjuvant therapy remains unexplored. This study aimed to explore the role of TRG and other clinical characteristics in predicting the efficacy of postoperative adjuvant therapy in ESCC patients receiving neoadjuvant therapy.
Methods
This study included patients who underwent R0 esophagectomy for thoracic ESCC after neoadjuvant therapy between January 2016 and December 2021 across three high-volume centers. Patients were assessed by TRG and divided into good responders (TRG 0–1) and poor responders (TRG 2–3).
Results
Among 416 patients with a median follow-up of 52 months, adjuvant therapy extended median survival by 8 months, which was statistically insignificant (p = 0.28). In the TRG 0–1 subgroup, those receiving adjuvant therapy had 3-year and 5-year OS rates of 94.6% and 86.8%, compared to 78.8% and 71.6% for the observation group (p = 0.02). Multivariable Cox regression showed adjuvant therapy was associated with reduced mortality in the TRG 0–1 (HR 0.32; 95% CI 0.14–0.73; p = 0.006), positive lymph nodes (HR 0.53; 95% CI 0.36–0.78; p = 0.001), and ypT3-4 subgroups (HR 0.63; 95% CI 0.43–0.92; p = 0.017).
Conclusions
TRG is a promising predictor of the prognostic value of adjuvant therapy in ESCC patients. Patients with a good TRG response, positive lymph nodes, and ypT3-4 stage benefit from adjuvant therapy.
期刊介绍：
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.
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