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• W2049477032 abstract "Purpose/Objective(s)This retrospective 15-year study assessed whether the tumor regression grading (TRG) could be used to predict treatment outcome of rectal cancer patients after preoperative chemoradiation therapy.Materials/MethodsBetween January 1998 and December 2012, 257 patients treated at our hospital were enrolled. Preoperative chemoradiation therapy was given by 5-fuorouracil continuous infusion during the first and fifth week, delivered with concurrent pelvic radiation of 45-50 Gy, followed by curative resection at 4-6 weeks. TRG was evaluated on excised specimens and was divided into five grades based on the relative amount of fibrosis in the tumor embedding area. Clinicopathologic factors, stages, TRG and prognosis, were statistical analyzed.ResultsThree groups were used: TRG 4 (complete response), TRG 2-3 (> 25% regression) and TRG 0-1 (< 25% response). TRG 4, 2-3, 0-1 were found in 9.7%, 68.5%, 21.5% of the resected specimens. Five-year overall survival (OS) after preoperative chemoradiation therapy and curative resection was 91% for TRG 4, 74% for grouped TRG 2-3, and 43% for grouped TRG 0-1 (P = .037). Moreover, patients with better tumor regression (4 vs 2-3 vs 0-1) also have better results for 5-year local-free (LFS), disease-free (DFS), and metastases free survival (MFS) (P = .004, P = .002, and P = .0001, respectively). On multivariate analysis, the vascular invasion on pathologic specimens and TRG after preoperative chemoradiation therapy were the most important independent prognostic factors for LFS and DFS, except MFS.ConclusionsTRG is considered to be a significant prognostic factor. Complete (TRG 4) and intermediate pathologic response (TRG 2-3) closely correlates with better survival and low local recurrence. However, in our results, TRG could not predict distant metastases. Purpose/Objective(s)This retrospective 15-year study assessed whether the tumor regression grading (TRG) could be used to predict treatment outcome of rectal cancer patients after preoperative chemoradiation therapy. This retrospective 15-year study assessed whether the tumor regression grading (TRG) could be used to predict treatment outcome of rectal cancer patients after preoperative chemoradiation therapy. Materials/MethodsBetween January 1998 and December 2012, 257 patients treated at our hospital were enrolled. Preoperative chemoradiation therapy was given by 5-fuorouracil continuous infusion during the first and fifth week, delivered with concurrent pelvic radiation of 45-50 Gy, followed by curative resection at 4-6 weeks. TRG was evaluated on excised specimens and was divided into five grades based on the relative amount of fibrosis in the tumor embedding area. Clinicopathologic factors, stages, TRG and prognosis, were statistical analyzed. Between January 1998 and December 2012, 257 patients treated at our hospital were enrolled. Preoperative chemoradiation therapy was given by 5-fuorouracil continuous infusion during the first and fifth week, delivered with concurrent pelvic radiation of 45-50 Gy, followed by curative resection at 4-6 weeks. TRG was evaluated on excised specimens and was divided into five grades based on the relative amount of fibrosis in the tumor embedding area. Clinicopathologic factors, stages, TRG and prognosis, were statistical analyzed. ResultsThree groups were used: TRG 4 (complete response), TRG 2-3 (> 25% regression) and TRG 0-1 (< 25% response). TRG 4, 2-3, 0-1 were found in 9.7%, 68.5%, 21.5% of the resected specimens. Five-year overall survival (OS) after preoperative chemoradiation therapy and curative resection was 91% for TRG 4, 74% for grouped TRG 2-3, and 43% for grouped TRG 0-1 (P = .037). Moreover, patients with better tumor regression (4 vs 2-3 vs 0-1) also have better results for 5-year local-free (LFS), disease-free (DFS), and metastases free survival (MFS) (P = .004, P = .002, and P = .0001, respectively). On multivariate analysis, the vascular invasion on pathologic specimens and TRG after preoperative chemoradiation therapy were the most important independent prognostic factors for LFS and DFS, except MFS. Three groups were used: TRG 4 (complete response), TRG 2-3 (> 25% regression) and TRG 0-1 (< 25% response). TRG 4, 2-3, 0-1 were found in 9.7%, 68.5%, 21.5% of the resected specimens. Five-year overall survival (OS) after preoperative chemoradiation therapy and curative resection was 91% for TRG 4, 74% for grouped TRG 2-3, and 43% for grouped TRG 0-1 (P = .037). Moreover, patients with better tumor regression (4 vs 2-3 vs 0-1) also have better results for 5-year local-free (LFS), disease-free (DFS), and metastases free survival (MFS) (P = .004, P = .002, and P = .0001, respectively). On multivariate analysis, the vascular invasion on pathologic specimens and TRG after preoperative chemoradiation therapy were the most important independent prognostic factors for LFS and DFS, except MFS. ConclusionsTRG is considered to be a significant prognostic factor. Complete (TRG 4) and intermediate pathologic response (TRG 2-3) closely correlates with better survival and low local recurrence. However, in our results, TRG could not predict distant metastases. TRG is considered to be a significant prognostic factor. Complete (TRG 4) and intermediate pathologic response (TRG 2-3) closely correlates with better survival and low local recurrence. However, in our results, TRG could not predict distant metastases." @default.
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• W2049477032 date "2014-09-01" @default.
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• W2049477032 title "Importance of Tumor Regression Grading in Predicting the Outcome for Patients With Rectal Cancer After Preoperative Chemoradiation Therapy" @default.
• W2049477032 doi "https://doi.org/10.1016/j.ijrobp.2014.05.1240" @default.
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