Tumor regression grade as a prognostic factor in metastatic colon cancer following preoperative chemotherapy

2021 ◽  
Author(s):  
Yufei Yang ◽  
Dakui Luo ◽  
Ruoxin Zhang ◽  
Sanjun Cai ◽  
Qingguo Li ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Prognostic Factor ◽  
Preoperative Chemotherapy ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Metastatic Colon Cancer ◽  
Regression Grade

Histological tumor regression after preoperative chemotherapy for colorectal liver metastases: Correlations with radiological response and prognosis.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 609-609
Author(s):  
Ryo Inada ◽  
Shigeyoshi Iwamoto ◽  
Masaki Kaibori ◽  
Morihiko Ishizaki ◽  
Hiroya Iida ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Liver Metastases ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Tumor Regression ◽  
Molecular Target ◽  
Tumor Regression Grade ◽  
Major Response ◽  
Radiological Response ◽  
Regression Grade

609 Background: The purpose of this study was to characterize histological tumor regression grade (TRG) to colorectal liver metastases (CLM) treated with preoperative chemotherapy followed by liver surgery, and to evaluate whether TRG correlates with radiological response and prognosis. Methods: This study included 30 patients with CLM treated by surgical resection after preoperative chemotherapy with oxaliplatin- or irrinotecan-based regimens with or without molecular target agents. TRG was determined by the amount of fibrosis and necrosis replaced from tumor cells, ranging TRG 0 (0%), 1 (1-24%), 2 (25-50%), 3 (51-99%), and 4 (100%). Results: TRG 0, 1, 2, 3, and 4 were observed in 0%, 6.7%, 10.0%, 66.7%, and 16.6% of the patients, respectively. There were no relations between TRG and regimen, including molecular target agents. As shown in the table, radiological response was not significantly correlated with TRG. Patients with histological major response (TRG 3+4) had better prognosis (MST; TRG 1+2 vs. 3+4: 20.0 vs. 50 months, P= 0.007), and a multivariate analysis identified histological major response as an independent good prognostic factor. Conclusions: In this analysis, histological TRG predicted survival after preoperative chemotherapy and resection for CLM. Preoperative radiological response could not evaluate TRG. [Table: see text]

scholarly journals Significance of chemotherapy-free interval and tumor regression grade in patients with recurrent esophageal squamous cell carcinoma receiving chemotherapy with fluorouracil and platinum after esophagectomy following preoperative chemotherapy

Esophagus ◽  
2021 ◽  
Author(s):  
Mashiro Okunaka ◽  
Daisuke Kotani ◽  
Ken Demachi ◽  
Hisashi Fujiwara ◽  
Shingo Sakashita ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Preoperative Chemotherapy ◽  
Squamous Cell ◽  
Recurrent Disease ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Free Interval ◽  
Regression Grade

Abstract Background In Japan, standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC) includes preoperative chemotherapy with fluorouracil plus cisplatin followed by esophagectomy. However, its efficacy is unclear in patients with recurrent disease with < 6 months of chemotherapy-free interval (CFI) after preoperative chemotherapy followed by esophagectomy and in those with ≥ 6 months of CFI and poor pathological response to prior preoperative chemotherapy. Method We retrospectively evaluated the efficacy of fluorouracil plus platinum in patients with recurrent ESCC who received preoperative chemotherapy followed by curative esophagectomy. Results Among 105 patients with recurrent ESCC after preoperative chemotherapy followed by esophagectomy, a total of 55 patients received fluorouracil plus platinum for recurrent disease. Patients with a CFI < 6 months (n = 20) had significantly shorter overall survival (OS) (median, 7.1 vs 14.5 months, P = 0.008) compared with those with a CFI ≥ 6 months (n = 35). Multivariate analysis showed that OS was worse in patients with a CFI < 6 months or a tumor regression grade (TRG) ≤ 1a. Furthermore, in patients with a CFI ≥ 6 months, TRG ≤ 1a was associated with significantly shorter OS (11.1 months vs. not reached, P = 0.001). Conclusion Fluorouracil plus platinum was ineffective for recurrent ESCC in patients with a CFI < 6 months and in those with a CFI ≥ 6 months and a TRG ≤ 1a. Alternate regimens including nivolumab or pembrolizumab might be considered for the treatment for recurrence in these patients.

Neoadjuvant treatment of adenocarcinoma of the rectum: Historical analysis and correlation between pathological regression rate and the outcomes.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15177-e15177
Author(s):  
Jeziel Basso ◽  
Sergio Jobim Azevedo ◽  
Marta Nassif Pereira Lima ◽  
Daniel C. Damin ◽  
Pedro Emanuel Rubini Liedke ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Adverse Event Rate ◽  
Tumor Regression Grade ◽  
Regression Rate ◽  
Important Prognostic Factor ◽  
Regression Grade

e15177 Background: Treatment of locally advanced rectal cancer is based on chemoradiation associated with surgery. This treatment has high potential for curability. Tumor regression grade appears to be a prognostic factor and be influenced by the timing of surgery. Methods: A retrospective database was formed. We included patients submitted to neoadjuvant chemoradiotherapy and rectal surgery, treated at the Hospital de Clínicas, Porto Alegre. We analyzed outcomes, pathologic and treatment toxicity data. TRG was mensurated by the modified Ryan method, as the AJCC. We sought to analyze the better timing for surgery after chemotherapy, comparing the weeks after surgery with the rate of pCR. Statistical analysis was done with Kaplan Meier, Pearson's Chi-square and the Cox regression method. Results: We accrued 156 patients between 2006 and 2018. The rate of PFS at 3 and 5 years were 75% and 70%, respectively. The 5-year overall survival was 91%. The rate of pCR was 12.8%. TRG was an important prognostic factor. The absence of a pathological response (TRG 3) was associated with an increase in mortality, HR 3,148 (95% CI 1.6-12.2 P 0.003) and a decrease in PFS, HR 3,148 (95% CI 1, 7-5.8 P 0.0001). The 5-years PFS with TRG 0,1, 2 and 3 were 95%, 87%, 73.3% and 48%, respectively. Comparing the time between neoadjuvant treatment and surgery of less than 8 weeks versus 8 and 12 weeks versus above 12 weeks, the rates of pCR were 4.3%, 18.6% and 7.1% and the rates of TRG 3 were 32,6%, 18,6% and 57,1% (P 0.016). The chemotherapy regimens included 5FU bolus (75.1%) and capecitabine (19.1%). Doses of radiotherapy above 45 Gy were received by 80.5% of patients. Adjuvant treatment was not performed in 30.6% and 16.6% of these cases had positive pathological lymph nodes. The grade 3/4 adverse event rate was 21.6%. Conclusions: The outcomes found are favorable. The pathological tumor regression grade is an important prognostic factor. New strategies such as total neoadjuvant may play a role considering the rate of patients who cannot perform adjuvant chemotherapy. The time after neoadjuvant treatment seems to influence the tumor regression rate, especially between 8 and 12 weeks.

scholarly journals Naples Prognostic Score Predicts Tumor Regression Grade in Resectable Gastric Cancer Treated with Preoperative Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4676
Author(s):  
Eva Lieto ◽  
Annamaria Auricchio ◽  
Giuseppe Tirino ◽  
Luca Pompella ◽  
Iacopo Panarese ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Preoperative Chemotherapy ◽  
Multimodal Treatment ◽  
Tumor Regression ◽  
Prognostic Score ◽  
Tumor Regression Grade ◽  
Term Survival ◽  
Gastric Cancer Patients ◽  
Regression Grade

Despite recent progresses, locally advanced gastric cancer remains a daunting challenge to embrace. Perioperative chemotherapy and D2-gastrectomy depict multimodal treatment of gastric cancer in Europe, shows better results than curative surgery alone in terms of downstaging, micrometastases elimination, and improved long-term survival. Unfortunately, preoperative chemotherapy is useless in about 50% of cases of non-responder patients, in which no effect is registered. Tumor regression grade (TRG) is directly related to chemotherapy effectiveness, but its understanding is achieved only after surgical operation; accordingly, preoperative chemotherapy is given indiscriminately. Conversely, Naples Prognostic Score (NPS), related to patient immune-nutritional status and easily obtained before taking any therapeutic decision, appeared an independent prognostic variable of TRG. NPS was calculated in 59 consecutive surgically treated gastric cancer patients after neoadjuvant FLOT4-based chemotherapy. 42.2% of positive responses were observed: all normal NPS and half mild/moderate NPS showed significant responses to chemotherapy with TRG 1–3; while only 20% of the worst NPS showed some related benefits. Evaluation of NPS in gastric cancer patients undergoing multimodal treatment may be useful both in selecting patients who will benefit from preoperative chemotherapy and for changing immune-nutritional conditions in order to improve patient’s reaction against the tumor.

Rectal cancer – current treatment strategy and the tumor regression grade evaluation after neoadjuvant therapy in patients who underwent surgery at the I. Department of Surgery, General University Hospital in Prague between 2012 and 2016

2021 ◽  
Vol 100 (2) ◽  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Tumor Regression ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Current Treatment ◽  
University Hospital ◽  
Tumor Regression Grade ◽  
Oncological Treatment ◽  
Regression Grade

Introduction: The article contains a summary of the issues of staging and therapy with an emphasis on the neoadjuvant treatment and associated tumor regression grade with the analysis of our own group of patients. Methods: Retrospective analysis of patients with rectal cancer who underwent a surgery at the 1st Department of Surgery – Thoratic, Abdominal and Injury Surgery; First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic, focusing on those who underwent neoadjuvant chemoradiotherapy and their pathologists evaluated tumor regression grade after the resection. Results: The group consists of 161 patients operated on between 2012 and 2016. 47 patients underwent neoadjuvant oncological treatment with further evaluation of the tumor regression grade by a pathologist, a scoring system according to Ryan was used. A complete pathological response was elicited in 10.4% of patients, no response in 35.4% of patients, and partial tumor regression in 54.2%. Conclusion: Although there is a difference in our results compared to foreign publications, the proportion of patients remains comparable. Studies evaluating the advantages versus disadvantages of neoadjuvant therapy will certainly follow, and the question of the suitability of surgical treatment as the only curative solution is partially raised.

Sign in / Sign up

Export Citation Format

Share Document