Tumor regression grade and survival after neoadjuvant treatment in gastro-esophageal cancer: A meta-analysis of 17 published studies

2017 ◽  
Vol 43 (9) ◽  
pp. 1607-1616 ◽  
Author(s):  
G. Tomasello ◽  
F. Petrelli ◽  
M. Ghidini ◽  
E. Pezzica ◽  
R. Passalacqua ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Regression ◽  
Meta Analysis ◽  
Neoadjuvant Treatment ◽  
Tumor Regression Grade ◽  
Regression Grade

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.

scholarly journals Pathological tumor regression grade of metastatic tumors in lymph node predicts prognosis in esophageal cancer patients

2018 ◽  
Vol 109 (6) ◽  
pp. 2046-2055 ◽  
Author(s):  
Tomohiro Kadota ◽  
Ken Hatogai ◽  
Tomonori Yano ◽  
Takeo Fujita ◽  
Takashi Kojima ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Metastatic Tumors ◽  
Regression Grade

scholarly journals Factors associated with rectal tumor and their influence on tumor regression grade after neoadjuvant chemoradiotherapy

2018 ◽  
Vol 99 (4) ◽  
pp. 611-616
Author(s):  
Yu R Aliyarov
Keyword(s):  
Treatment Effect ◽  
Tumor Response ◽  
Tumor Regression ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Rectal Tumor ◽  
Chemoradiation Therapy ◽  
Tumor Regression Grade ◽  
Grade 3 ◽  
Regression Grade

Aim. To determine relation between localization, grade of invasion and differentiation in rectal tumor and tumor regression grade after neoadjuvant chemoradiation therapy. Methods. 88 patients with local advanced rectal cancer (Т2-4N0-2М0) were analyzed: 46 females and 42 males. The average age was 52.4±1.4 years. All patients underwent neoadjuvant chemoradiotherapy. In all groups regardless of tumor localization patients with stage T3 and moderate differentiation grade predominated. Results. Complete pathological tumor response of grade 4 (TRG4) was revealed in 13 (14.7%) patients, grade 3 (TRG3) in 34 (38.6%) patients, low treatment effect (tumor response grade 2, TRG2) was registered in 26 (29.5%) patients, and lack of treatment effect (grade 1, TRG1) in 15 (17.2%) patients. Analysis of the data from patients with complete or nearly complete tumor regression (grade 3 and 4) demonstrated that such effect of neoadjuvant treatment was most often observed in patients with tumor localized in rectal lower ampulla (58.6%). Among patients with moderately differentiated adenocarcinomas, patients with tumor response of grade 3 and 4 predominated: 28 (56%) patients. According to invasion grade, in all groups patients with therapeutic response grade 3 and 4 prevailed, but most prominently - in groups of patients with stage T4a and T4b - 58.9%. Conclusion. The closer to anus tumor is located, the more significant effect neoadjuvant therapy has; moderate tumor differentiation grade can be considered as a relative predictive factor of tumor regression on preoperative chemoradiation therapy.

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 Prognostic relevance of lymph node regression on survival in esophageal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Eliza Hagens ◽  
Karina Tukanova ◽  
Sara Jamel ◽  
Mark van Berge Henegouwen ◽  
George B Hanna ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Neoadjuvant Therapy ◽  
Tumor Regression ◽  
Average Rate ◽  
Meta Analysis ◽  
Neoadjuvant Treatment ◽  
Term Survival ◽  
Number Of Patients ◽  
The Impact

Summary Introduction The prognostic value of histomorphologic regression in primary esophageal cancer has been previously established, however the impact of lymph node (LN) response on survival still remains unclear. The aim of this review was to assess the prognostic significance of LN regression or downstaging following neoadjuvant therapy for esophageal cancer. Methods An electronic search was performed to identify articles evaluating LN regression or downstaging after neoadjuvant therapy. Random effects meta-analyses were performed to assess the influence of regression in the LNs and nodal downstaging on overall survival. Histomorphologic tumor regression in LNs was defined by the absence of viable cells or degree of fibrosis on histopathologic examination. Downstaged LNs were defined as pN0 nodes by the tumor, node, and metastasis classification, which were positive prior to treatment neoadjuvant. Results Eight articles were included, three of which assessed tumor regression (number of patients = 292) and five assessed downstaging (number of patients = 1368). Complete tumor regression (average rate of 29.1%) in the LNs was associated with improved survival, although not statistically significant (hazard ratio [HR] = 0.52, 95% confidence interval [CI] = 0.26–1.06; P = 0.17). LNs downstaging (average rate of 32.2%) was associated with improved survival compared to node positivity after neoadjuvant treatment (HR = 0.41, 95%CI = 0.22–0.77; P = 0.005). Discussion The findings of this meta-analysis have shown a survival benefit in patients with LN downstaging and are suggestive for considering LN downstaging to ypN0 as an additional prognostic marker in staging and in the comparative evaluation of differing neoadjuvant regimens in clinical trials. No statistically significant effect of histopathologic regression in the LNs on long-term survival was seen.

scholarly journals Treatment monitoring of locally advanced rectal cancer based on multiparametric magnetic resonance tomography

2020 ◽  
Vol 10 (1) ◽  
pp. 20-27
Author(s):  
P. Yu. Grishko ◽  
A. V. Mishchenko ◽  
O. V. Ivko ◽  
D. V. Samsonov ◽  
A. M. Karachun
Keyword(s):  
Magnetic Resonance ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Venous Invasion ◽  
Tumor Regression Grade ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Predicting Factors ◽  
Regression Grade

Objective: to determine the predicting factors for the effectiveness of neoadjuvant treatment in colorectal cancer based on the analysis of overall and relapse-free survival, as well as the possibility of multiparametric magnetic resonance imaging (MRI) in stratifying patients into groups with favorable and unfavorable clinical course.Materials and methods. 112 patients who received preoperative chemoradiotherapy (n = 85) and chemoradiotherapy supplemented with neoadjuvant polychemotherapy (n = 27) followed by surgery were enrolled in retrospective study. To determine the most significant predicting factors and criteria for evaluating the effectiveness of treatment that affect overall and relapse-free survival, Kaplan–Meier estimator and Cox regression were used.Results. The relapse-free survival was significantly affected by the presence or absence of extramural venous invasion according to MRI (mrEMVI) (p = 0.0001), circumferential resection margin status according to pathomorphological data (pCRM) (p = 0.031), change in volume of tumor (mrVolumetric analysis) (p = 0.015), tumor regression grade according to MRI (mrTRG) (p = 0.017) and pathomorphological data (pTRG) (p = 0.038). Independent predictors of overall survival were: extramural venous invasion according to MRI (mrEMVI) (p = 0.0001), posttreatment N staging (p = 0.047) and tumor regression grade according to MRI (mrTRG) (p = 0.059). Based on the most significant MR criteria, a mathematical model was developed to predict the risk of relapse after neoadjuvant treatment.Conclusions. MRI allows stratifying patients into groups with a favorable and unfavorable prognosis at the preoperative stage and optimizing the management of patients after surgery taking into account pathomorphological data.

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