Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer: a cross sectional multicentric experience
| Autor: | Germani P., Di Candido F., Leonard D., Cuicchi D., Elmore U., Allaix M. E., Barbieri V. P., D'Allens L., Faes S., Milani M., Caputo D., Martinez C., Grosek J., Caracino V., Christou N., Roodbeen S. X., Bracale U., Wildeboer A., Usai A., Benedetti M., Balani A., Piccinni G., Catarci M., Millo P., Bouvy N., Corcione F., Hompes R., Ris F., Basti M., Tomazic A., Targarona E., Coppola A., Pietrabissa A., Hahnloser D., Adamina M., Viola M., Morino M., Rosati R., Poggioli G., Kartheuser A., Spinelli A., de Manzini N., Bellio G., Iacuzzo C., Zucca A., Corleone P., Giudici F., Palmisano S., Carvello M., Remue C., Bachmann R., Lombard N., Pirlet C., Ryckx A., Massaron S., Pugliese L., Coppola R., Ferrari C., Castiglioni S., Ponte E., Concina S., Piveteau A., An Y., Cagnazzo E., Troian M. |
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| Přispěvatelé: | Germani, Paola, Di Candido, Francesca, Léonard, Daniel, Cuicchi, Dajana, Elmore, Ugo, Allaix, Marco Ettore, Barbieri, Vittoria Pia, D'Allens, Laura, Faes, Seraina, Milani, Marika, Caputo, Damiano, Martinez, Carmen, Grosek, Jan, Caracino, Valerio, Christou, Niki, Roodbeen, Sapho X, Bracale, Umberto, Wildeboer, Aurelia, Usai, Antonella, Benedetti, Michele, Balani, Alessandro, Piccinni, Giuseppe, Catarci, Marco, Millo, Paolo, Bouvy, Nicole, Corcione, Francesco, Hompes, Roel, Ris, Frédéric, Basti, Massimo, Tomazic, Ale, Targarona, Eduardo, Coppola, Alessandro, Pietrabissa, Andrea, Hahnloser, Dieter, Adamina, Michel, Viola, Massimo, Morino, Mario, Rosati, Riccardo, Poggioli, Gilberto, Kartheuser, Alex, Spinelli, Antonino, de Manzini, Nicolò, Palmisano, Silvia, TRG Snapshot Study Group, Bellio, G., Iacuzzo, C., Zucca, A., Corleone, P., Giudici, F., Palmisano, S., Carvello, M., Remue, C., Bachmann, R., Lombard, N., Pirlet, C., Ryckx, A., Massaron, S., Pugliese, L., Coppola, R., Ferrari, C., Castiglioni, S., Ponte, E., Concina, S., Piveteau, A., An, Y., Cagnazzo, E., Troian, M., Surgery, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, Germani P., Di Candido F., Leonard D., Cuicchi D., Elmore U., Allaix M.E., Barbieri V.P., D'Allens L., Faes S., Milani M., Caputo D., Martinez C., Grosek J., Caracino V., Christou N., Roodbeen S.X., Bracale U., Wildeboer A., Usai A., Benedetti M., Balani A., Piccinni G., Catarci M., Millo P., Bouvy N., Corcione F., Hompes R., Ris F., Basti M., Tomazic A., Targarona E., Coppola A., Pietrabissa A., Hahnloser D., Adamina M., Viola M., Morino M., Rosati R., Poggioli G., Kartheuser A., Spinelli A., de Manzini N., Bellio G., Iacuzzo C., Zucca A., Corleone P., Giudici F., Palmisano S., Carvello M., Remue C., Bachmann R., Lombard N., Pirlet C., Ryckx A., Massaron S., Pugliese L., Coppola R., Ferrari C., Castiglioni S., Ponte E., Concina S., Piveteau A., An Y., Cagnazzo E., Troian M., UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer medicine.medical_treatment THERAPY CHEMORADIOTHERAPY Neoadjuvant therapy Pathologic complete response Rectal cancer Tumor regression grade Chemoradiotherapy Cross-Sectional Studies Humans Neoadjuvant Therapy Neoplasm Staging Rectal Neoplasms/diagnostic imaging Rectal Neoplasms/surgery Rectum/pathology Treatment Outcome EXCISION 03 medical and health sciences 0302 clinical medicine NEOADJUVANT CHEMORADIATION medicine PREOPERATIVE RADIOTHERAPY Cross-Sectional Studie Tumor Regression Grade ddc:617 medicine.diagnostic_test Rectal Neoplasms business.industry Standard treatment Rectum Cancer Magnetic resonance imaging medicine.disease Surgery Exact test 030220 oncology & carcinogenesis Original Article 030211 gastroenterology & hepatology Radiology FOLLOW-UP business Human MRI |
| Zdroj: | Updates in Surgery, Vol. 73, No 5 (2021) pp. 1795-1803 Updates in surgery, vol. 73, no. 5, pp. 1795-1803 Updates in Surgery, 73(5), 1795-1803. Springer Verlag Updates in surgery, 73(5), 1795-1803. Springer-Verlag Italia Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona Updates in Surgery Updates in surgery, Vol. 73, no. 5, p. 1795-1803 (2021) |
| ISSN: | 2038-131X |
| Popis: | Pre-operative chemoradiotherapy (CRT) followed by surgical resection is still the standard treatment for locally advanced low rectal cancer. Nowadays new strategies are emerging to treat patients with a complete response to pre-operative treatment, rendering the optimal management still controversial and under debate. The primary aim of this study was to obtain a snapshot of tumor regression grade (TRG) distribution after standard CRT. Second, we aimed to identify a correlation between clinical tumor stage (cT) and TRG, and to define the accuracy of magnetic resonance imaging (MRI) in the restaging setting. Between January 2017 and June 2019, a cross sectional multicentric study was performed in 22 referral centers of colon-rectal surgery including all patients with cT3-4Nx/cTxN1-2 rectal cancer who underwent pre-operative CRT. Shapiro–Wilk test was used for continuous data. Categorical variables were compared with Chi-squared test or Fisher’s exact test, where appropriate. Accuracy of restaging MRI in the identification of pathologic complete response (pCR) was determined evaluating the correspondence with the histopathological examination of surgical specimens.In the present study, 689 patients were enrolled. Complete tumor regression rate was 16.9%. The “watch and wait” strategy was applied in 4.3% of TRG4 patients. A clinical correlation between more advanced tumors and moderate to absent tumor regression was found (p = 0.03). Post-neoadjuvant MRI had low sensibility (55%) and high specificity (83%) with accuracy of 82.8% in identifying TRG4 and pCR.Our data provided a contemporary description of the effects of pre-operative CRT on a large pool of locally advanced low rectal cancer patients treated in different colon-rectal surgical centers. |
| Databáze: | OpenAIRE |
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