Comparison of five tumor regression grading systems for gastric adenocarcinoma after neoadjuvant chemotherapy: a retrospective study of 192 cases from National Cancer Center in China

Autor: Yong Jiang, Shangying Hu, Liyan Xue, Yue-Lu Zhu, Yong-Kun Sun, Jiang-Ying Yue, Xuemin Xue, Lin Yang
Rok vydání: 2017
Předmět:
Male
Oncology
Organoplatinum Compounds
Pyridines
medicine.medical_treatment
Perineural invasion
Docetaxel
Gastroenterology
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
Remission Induction
Hazard ratio
General Medicine
Middle Aged
Prognosis
Neoadjuvant Therapy
Tumor Burden
Tumor regression grading
Oxaliplatin
Drug Combinations
Treatment Outcome
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Adenocarcinoma
Female
Taxoids
030211 gastroenterology & hepatology
Esophagogastric Junction
Fluorouracil
Research Article
Adult
China
medicine.medical_specialty
Neoadjuvant chemotherapy
Disease-Free Survival
03 medical and health sciences
Gastrectomy
Stomach Neoplasms
Internal medicine
medicine
Humans
Neoplasm Invasiveness
Grading (tumors)
Survival analysis
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Tegafur
Chemotherapy
business.industry
Retrospective cohort study
Hepatology
medicine.disease
Survival Analysis
Oxonic Acid
Multivariate Analysis
Cisplatin
Gastric cancer
business
Zdroj: BMC Gastroenterology
ISSN: 1471-230X
Popis: Background Neoadjuvant chemotherapy has been increasingly practiced on gastric cancer (GC), and histological evaluation to predict outcome is urgent in clinical practice. There are five classic tumor regression grading (TRG) systems, including Mandard-TRG system, the Japanese Gastric Cancer Association (JGCA)-TRG system, College of American Pathologists (CAP)-TRG system, China-TRG system and Becker-TRG system. Methods Totally, 192 patients of gastric adenocarcinoma (including adenocarcinoma of the esophagogastric junction) treated by neoadjuvant chemotherapy and surgery were evaluated using the above five TRG systems. The clinicopathological characteristics were also assessed. The correlation among TRG systems, clinicopathological characteristics and prognosis were analyzed. Results All the five TRG systems were significantly correlated with differentiation, postsurgical T category, postsurgical N category, American Joint Committee on Cancer (AJCC) stage, lymph-vascular invasion, perineural invasion, as well as tumor size. All the five TRG systems were statistically significant in univariate Cox survival analysis. However, only postsurgical T category, postsurgical N category and R0 resection were independent in multivariate Cox survival analysis. The tight correlation between the TRG systems and other characteristics such as postsurgical stage might affect the independent prognostic role of the TRG systems. As compared with other TRG systems, the hazard ratio of no/slightly response in both Mandard TRG system and JGCA TRG system revealed higher hazard of death and disease progression than that of severe response when using univariate Cox survival analysis. The median survival time of complete response and nearly complete response were much longer than that of partial response, all classified by Mandard-TRG system. This could help clinicians predict prognosis more reasonably than JGCA-TRG which does not have the category of nearly complete response. Conclusion We recommend Mandard-TRG system for GC after neoadjuvant chemotherapy due to its better prediction of prognosis.
Databáze: OpenAIRE
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