Role of neoadjuvant therapy(chemotherapy and/or radiotherapy) in lymph node and primary rectal tumor regression and prognosis (Preprint)

2021 ◽  
Author(s):  
Mahshid Kashkoulibehroozi ◽  
Shirin Tahereh Haghighi ◽  
Zhale Mohsenifar
Keyword(s):  
Lymph Node ◽  
Neoadjuvant Therapy ◽  
Tumor Regression ◽  
Rectal Tumor ◽  
Tumor Regression Grade ◽  
Rectal Tumors ◽  
N Stage ◽  
Prediction Of Prognosis ◽  
Regression Grade

UNSTRUCTURED Background: Rectal tumors are important malignancies and prediction of prognosis after neoadjuvant therapy is important to improve the prognosis process. The purpose of this study was to determine therole ofneoadjuvant therapy in lymph node regression and primary rectal tumor as well as its association with prognosis. Methods and materials: In this descriptive study, 40 consecutive patients with rectal tumor who were referred toTaleghani Hospital for surgery from 2011 to 2018 were enrolled. Moreover, theneoadjuvant therapy role in lymph node regression and primary rectal tumor was determined as well as its association with prognosis. Results: The results of this study demonstrate that there was no tumor regression in 20% of patients and it wasalso less than 25%, 25-50%, 50-75%, and complete in 22.5%, 35%, 20%, and 2.5% of the patients,respectively. The lymph node regression was complete in 5% of the patients and it wasalso less than 25% in 20% and more than 25% in 50% of them. In addition, it was with no regression in 25% of the patients. The lymph node regression was related to N stage (P=0.018), primary tumor regression grade (P=0.001), yPT (P=0.008), and yPN (P=0.020); however, it was not related to prognosis (P > 0.05). Conclusions: Totally, according to the obtained results, it can be concluded thatneoadjuvant therapy plays a good role in lymph node regression and primary rectal tumor, but it has no association with prognosis. Keywords:Neoadjuvant therapy, Lymph node regression, Primary rectal tumor, Prognosis

scholarly journals Density and distribution of lymphocytes in pretherapeutic rectal cancer and response to neoadjuvant therapy

2020 ◽  
Author(s):  
Sicong Lai ◽  
Xiaoying Lou ◽  
Xinjuan Fan ◽  
Weipeng Sun ◽  
Yanhong Deng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Tumor Regression ◽  
Tumor Infiltrating Lymphocytes ◽  
Sensitivity Analyses ◽  
Tumor Regression Grade ◽  
Cancer Tissue ◽  
Infiltrating Lymphocytes ◽  
Regression Grade

Abstract Background Lymphocytic density in rectal cancer has been reported to be associated with therapeutic response, but the role of the lymphocytic distribution pattern remains to be determined. This study aimed to evaluate the association between the distribution and density of lymphocytes in rectal-cancer tissue with tumor response to neoadjuvant therapy. Methods We retrospectively analysed 134 patients with rectal cancer receiving neoadjuvant therapy within a prospectively maintained cohort. Pretherapeutic biopsy samples were stained with immunohistochemistry (CD4 and CD8). Densities of intratumoral periglandular lymphocytes (IPLs) and tumor-infiltrating lymphocytes (TILs) were assessed separately. Logistic-regression analysis was used to assess associations of lymphocyte densities with tumor regression grade (TRG), controlling for clinicopathological, molecular, and regimen features. Results Compared with cases in the lowest quartile of CD8+ TILs, those in the highest quartile were significantly associated with better TRG (multivariate odds ratio, 0.23; 95% confidence interval, 0.07 to 0.76; P < 0.001). In contrast, CD8+ IPLs, CD4+ IPLs, and CD4+ TILs were not significantly associated with TRG (P = 0.033, 0.156, and 0.170, respectively). Sensitivity analyses detected no interaction between CD8+ TILs and regimen of neoadjuvant radiation (Pinteraction = 0.831) or chemotherapy (Pinteraction = 0.879) on TRG. Conclusions Our data suggest that CD8+ TILs, but not IPLs, are independently associated with response to neoadjuvant therapy, regardless of the regimen of radiation or chemotherapy.

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 New tumor regression grade for rectal cancer after neoadjuvant therapy and radical surgery

Oncotarget ◽  
2015 ◽  
Vol 6 (39) ◽  
pp. 42222-42231 ◽  
Author(s):  
Jun Li ◽  
Hao Liu ◽  
Junjie Hu ◽  
Sai Liu ◽  
Jie Yin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Radical Surgery ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Regression Grade

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.

scholarly journals Tumor Regression Grade Predicts Survival in Locally Advanced Gastric Adenocarcinoma Patients with Lymph Node Metastasis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yilin Tong ◽  
Yanmei Zhu ◽  
Yan Zhao ◽  
Zexing Shan ◽  
Jianjun Zhang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Gastric Adenocarcinoma ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Prognostic Significance ◽  
Tumor Regression Grade ◽  
Node Metastasis ◽  
Advanced Gastric Adenocarcinoma ◽  
Regression Grade

Background. Tumor regression grade (TRG) is widely used in gastrointestinal carcinoma to evaluate pathological responses to neoadjuvant chemotherapy (NCT), but whether it is an independent prognostic factor is still controversial. The aim of this study is to investigate the value of TRG in locally advanced gastric adenocarcinoma patients who underwent NCT and curative resection. Methods. Pathological regression was reevaluated according to the Mandard TRG. Survival curves were obtained by the Kaplan–Meier method, and differences in overall survival (OS) and disease-free survival (DFS) were compared using the log-rank test. Univariate and multivariate analyses for survival were based on the Cox proportional hazards method. Results. In total, 290 patients were identified in our electronic database. In univariable analysis, TRG was associated with OS (HR=3.822, P≤0.001) and DFS (HR=3.374, P≤0.001). However, in multivariable analysis, TRG was not an independent factor for OS (P=0.231) or DFS (P=0.191). In the stratified analysis, TRG retrieved prognostic significance in patients with the metastasis of lymph node (HR=2.034, P=0.035 for OS; HR=2.220, P=0.016 for DFS), while not in patients with negative lymph node (P=0.296 for OS; P=0.172 for DFS). Conclusions. TRG was not an independent predictor for survival, but the system regained its predicting significance in patients with lymph node metastasis.

PO-1115: What's the role of tumor regression grade (TRG) in rectal cancer: an istututional experience

2020 ◽  
Vol 152 ◽  
pp. S589-S590
Author(s):  
A. Guaineri ◽  
L. Triggiani ◽  
F. Frassine ◽  
J. Imbrescia ◽  
F. Barbera ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Regression Grade

PS02.087: EARLY RESPONSE EVALUATION OF NEOADJUVANT THERAPY WITH PET/MRI TO PREDICT RESECTABILITY IN PATIENTS WITH ADENOCARCINOMA OF THE ESOPHAGOGASTRIC JUNCTION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 145-145
Author(s):  
Michael Achiam ◽  
Johan Löfgren ◽  
Mohamed Belmouhand ◽  
Helle Hjorth Johannesen ◽  
Lene Baeksgaard
Keyword(s):  
Neoadjuvant Therapy ◽  
Esophagogastric Junction ◽  
Tumor Regression ◽  
Tumor Regression Grade ◽  
Response Evaluation ◽  
Histopathological Response ◽  
Feasible Method ◽  
Radio Therapy ◽  
Insufficient Response ◽  
Regression Grade

Abstract Background The primary treatment for locally advanced adenocarcinoma of the esophagogastric junction remains surgery combined with neoadjuvant chemo- or chemoradiotherapy (NT). A prediction of response to NT would be valuable, as insufficient response following NT may reflect therapy resistance leading to disease progression, unnecessary delay of surgery and risk of unresectability. Determining insufficient response to NT could lead to change of therapy and reduce possible chemo(radio)therapy toxicity. Positron Emission Tomography (PET)/Magnetic Resonance Imaging (MRI) is a new modality that has showed promising results for various clinical indications. Currently, evaluation of neoadjuvant therapy (NT) among patients with adenocarcinoma of the esophagogastric junction has primary been reserved for PET/computed tomography (CT). The aim of this study was to investigate if simultaneous PET/MRI is a feasible method to evaluate early tumor response to predict resectability in patients with AEG during NT. We also examined the association between histopathological response and changes on PET/MRI during NT. Methods Patients with untreated adenocarcinoma of the esophagogastric junction (Siewert's I/II) and fit for NT with no contraindications for PET/MRI were considered eligible. A baseline scan was performed prior to NT induction and an evaluation scan 3 weeks later. For histopathological response evaluation the Mandard tumor regression grade score was applied. Response on PET/MRI was evaluated with Response Evaluation Criteria in Solid Tumors (RECIST 1.1), and change in ADC and SUVmax values. Results Twenty-eight patients were enrolled, and 22 completed both scans and proceeded to our final analyses. 17 patients were found resectable vs. five not resectable. PET/MRI response evaluation is a feasible method to predict resectability in patients with adenocarcinoma of the esophagogastric junction with sensitivity 94%, specificity 80%, and AUC = 0.95. However, no association with histopathological response (tumor regression grade) was found nor was RECIST correlated with resectability. Conclusion Our work has identified response evaluation with PET/MRI as a feasible method to predict resectability in patients with adenocarcinoma of the esophagogastric junction, however, larger studies are warranted to justify the use of this modality for this indication. Disclosure All authors have declared no conflicts of interest.

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