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学科主题: 临床医学
题名:
Tumor regression grades: Potential outcome predictor of locally advanced rectal adenocarcinoma after preoperative radiotherapy
作者: 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
发表日期: 2015-02-14
DOI: 10.3748/wjg.v21.i6.1851
卷: 21, 期:6, 页:1851-1856
收录类别: SCI
文章类型: Article
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
英文摘要:

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.

语种: 英语
所属项目编号: 81372593 ; 81030040 ; 81201965 ; 7132052 ; 2012AA02A506 ; SS2014AA020801 ; ZY201410 ; D0905001000011 ; D101100050010068
项目资助者: 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
WOS记录号: WOS:000349666300019
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54434
Appears in Collections:北京大学临床肿瘤学院_胃肠肿瘤中心_期刊论文

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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

Recommended Citation:
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.
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