A Modified Classification of Prognostic Factors Based on Pathological Stage and Tumor Regression Grade in Patients with Rectal Cancer Who Receive Preoperative Chemoradiotherapy
| Autor: | Toshiyuki Suzuki, Hiroshi Miyakita, Kazutake Okada, Hiroshi Yamamuro, Sotaro Sadahiro, Takeshi Akiba, Akira Tanaka, Gota Saito |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Colorectal cancer medicine.medical_treatment Preoperative care Gastroenterology Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Internal medicine Preoperative Care Medicine Humans Stage (cooking) Risk factor Neoadjuvant therapy Aged Neoplasm Staging Retrospective Studies Tumor Regression Grade Aged 80 and over business.industry Rectal Neoplasms Retrospective cohort study General Medicine Chemoradiotherapy Middle Aged medicine.disease Prognosis Combined Modality Therapy Neoadjuvant Therapy Surgery Oncology 030220 oncology & carcinogenesis Clinical Study 030211 gastroenterology & hepatology Female business |
| Popis: | Objective: The histologic response to neoadjuvant chemoradiotherapy (CRT) has been intimately related to outcomes in locally advanced rectal cancer. However, reliable prognostic factors have yet to be established. Subjects and Methods: The study group comprised 198 patients with locally advanced rectal cancer who received CRT. A modified classification based on the combination of ypStage and tumor regression grade (TRG) was developed. ypStage II with TRG 2 was classified as ypTRGstage IIA, and ypStage II with TRG 3 or 4 was classified as ypTRGstage IIB. ypStage 0 and ypStage I were classified as ypTRGstage I, and ypStage III was classified as ypTRGstage III. Results: The 5-year disease-free survival (DFS) was 83% in ypTRGstage I, 86% in ypTRGstage IIA, 57% in ypTRGstage IIB, and 60% in ypTRGstage III (p = 0.0001). The 5-year DFS in ypTRGstage IIA did not differ significantly from that in ypStage 0 (p = 0.865) or ypStage I (p = 0.585). The 5-year DFS in ypStage IIB did not differ from that in ypStage III (p = 0.912). Multivariate analysis showed that ypTRGstage was an independent risk factor for DFS. Conclusion: A modified classification allows patients with ypStage II locally advanced rectal cancer to be clearly divided into two groups: responders and nonresponders. |
| Databáze: | OpenAIRE |
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