|Tumor regression grades: Potential outcome predictor of locally advanced rectal adenocarcinoma after preoperative radiotherapy|
|Peng, Yi-Fan1; Yu, Wei-Dong2; Pan, Hong-Da1; Wang, Lin1; Li, Ming1; Yao, Yun-Feng1; Zhao, Jun1; Gu, Jin1|
|关键词||Tumor Regression Grade Preoperative Radiotherapy Rectal Adenocarcinoma Disease-free Survival|
|刊名||WORLD JOURNAL OF GASTROENTEROLOGY|
|WOS标题词||Science & Technology|
|类目[WOS]||Gastroenterology & Hepatology|
|研究领域[WOS]||Gastroenterology & Hepatology|
|关键词[WOS]||DISEASE-FREE SURVIVAL ; PROGNOSTIC VALUE ; NEOADJUVANT RADIOTHERAPY ; COLORECTAL-CANCER ; CHEMORADIOTHERAPY ; CARCINOMA ; TRIAL ; METASTASIS|
AIM: To analyze tumor regression grade (TRG) for prognosis of locally advanced rectal adenocarcinoma (LARA) treated with preoperative radiotherapy.
METHODS: One hundred and ninety patients with clinical stage II/III LARA were studied. All patients underwent radical surgery (between 2004 and 2010) after 30-Gy/10-fraction preoperative radiotherapy (pre-RT). All 190 patients received a short course of pre-RT and were reassessed for disease recurrence and survival; the slides of surgical specimens were reviewed and classified according to Mandard TRG. We compared patients with good response (Mandard TRG1 or TRG2) vs patients with bad/poor response (Mandard TRG3-5). Outcomes evaluated were 5-year overall survival (OS), 5-year disease-free survival (DFS), and local, distant and mixed recurrence. Fisher′s exact test or chi(2) test, log-rank test and proportional hazards regression analysis were used to calculate the probability that Mandard TRG was associated with patient outcomes.
RESULTS: One hundred and sixty-six of 190 patients (87.4%) were identified as Mandard bad responders (TRG3-5). High Mandard grade was correlated with tumor height (41.7% < 6 cm vs 58.3% >= 6 cm, P = 0.050), ypT stage (75% ypT0-2 vs 25% ypT3-4, P = 0.000), and ypN stage (75% ypN0 vs 25% ypN1, P = 0.031). In univariate survival analysis, Mandard grade bad responders had significantly worse OS and DFS than good responders (TRG1/2) (OS, 83.1% vs 96.4%, P = 0.000; DFS, 72.3% vs 92.0%, P = 0.002). In multivariate survival analysis, Mandard bad responders had significantly worse DFS than Mandard good responders (DFS 3.8 years (95% CI: 1.2-12.2 years, P = 0.026).
CONCLUSION: Mandard grade good responders had a favorable prognosis. TRG may be a potential predictor for DFS in LARA after pre-RT.
|项目编号||81372593 ; 81030040 ; 81201965 ; 7132052 ; 2012AA02A506 ; SS2014AA020801 ; ZY201410 ; D0905001000011 ; D101100050010068|
|资助机构||National Natural Science Foundation of China ; Beijing Natural Science Foundation ; National High Technology Research and Development Program of China (863 Program) ; Beijing Municipal Administration of Hospitals Special Fund for Clinical Medicine Development ; Beijing Science and Technology Commission|
|作者单位||1.Peking Univ, Canc Hosp & Inst, Dept Colorectal Surg, Minist Educ,Key Lab Carcinogenesis & Translat Res, Beijing 100142, Peoples R China|
2.Peking Univ, Peoples Hosp, Inst Clin Mol Biol, Beijing 100044, Peoples R China
|Peng, Yi-Fan,Yu, Wei-Dong,Pan, Hong-Da,et al. Tumor regression grades: Potential outcome predictor of locally advanced rectal adenocarcinoma after preoperative radiotherapy[J]. WORLD JOURNAL OF GASTROENTEROLOGY,2015,21(6):1851-1856.|
|APA||Peng, Yi-Fan.,Yu, Wei-Dong.,Pan, Hong-Da.,Wang, Lin.,Li, Ming.,...&Gu, Jin.(2015).Tumor regression grades: Potential outcome predictor of locally advanced rectal adenocarcinoma after preoperative radiotherapy.WORLD JOURNAL OF GASTROENTEROLOGY,21(6),1851-1856.|
|MLA||Peng, Yi-Fan,et al."Tumor regression grades: Potential outcome predictor of locally advanced rectal adenocarcinoma after preoperative radiotherapy".WORLD JOURNAL OF GASTROENTEROLOGY 21.6(2015):1851-1856.|