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.

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.

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.

The prognostic value of a modified tumor regression grade after neoadjuvant chemoradiotherapy and resection of esophageal carcinoma.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 4066-4066
Author(s):  
Maarten CJ Anderegg ◽  
Sjoerd M Lagarde ◽  
Wernard A Borstlap ◽  
Suzanne S Gisbertz ◽  
Sybren L. Meijer ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Prognostic Value ◽  
Tumor Regression ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumor Regression Grade ◽  
Regression Grade

scholarly journals Pre-Treatment T2-WI Based Radiomics Features for Prediction of Locally Advanced Rectal Cancer Non-Response to Neoadjuvant Chemoradiotherapy: A Preliminary Study

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1894 ◽  
Author(s):  
Bianca Petresc ◽  
Andrei Lebovici ◽  
Cosmin Caraiani ◽  
Diana Sorina Feier ◽  
Florin Graur ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Imaging Biomarkers ◽  
Tumor Regression Grade ◽  
Pre Treatment

Locally advanced rectal cancer (LARC) response to neoadjuvant chemoradiotherapy (nCRT) is very heterogeneous and up to 30% of patients are considered non-responders, presenting no tumor regression after nCRT. This study aimed to determine the ability of pre-treatment T2-weighted based radiomics features to predict LARC non-responders. A total of 67 LARC patients who underwent a pre-treatment MRI followed by nCRT and total mesorectal excision were assigned into training (n = 44) and validation (n = 23) groups. In both datasets, the patients were categorized according to the Ryan tumor regression grade (TRG) system into non-responders (TRG = 3) and responders (TRG 1 and 2). We extracted 960 radiomic features/patient from pre-treatment T2-weighted images. After a three-step feature selection process, including LASSO regression analysis, we built a radiomics score with seven radiomics features. This score was significantly higher among non-responders in both training and validation sets (p < 0.001 and p = 0.03) and it showed good predictive performance for LARC non-response, achieving an area under the curve (AUC) = 0.94 (95% CI: 0.82–0.99) in the training set and AUC = 0.80 (95% CI: 0.58–0.94) in the validation group. The multivariate analysis identified the radiomics score as an independent predictor for the tumor non-response (OR = 6.52, 95% CI: 1.87–22.72). Our results indicate that MRI radiomics features could be considered as potential imaging biomarkers for early prediction of LARC non-response to neoadjuvant treatment.

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