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What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy?
PURPOSE: Tumor regression grade (TRG) is predictive of therapeutic response in rectal cancer patients after chemoradiotherapy (CRT) followed by curative resection. However, various TRG systems have been suggested, with subjective categorization, resulting in interobserver variability. This study com...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Cancer Association
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946373/ https://www.ncbi.nlm.nih.gov/pubmed/26511803 http://dx.doi.org/10.4143/crt.2015.254 |
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author | Kim, Soo Hee Chang, Hee Jin Kim, Dae Yong Park, Ji Won Baek, Ji Yeon Kim, Sun Young Park, Sung Chan Oh, Jae Hwan Yu, Ami Nam, Byung-Ho |
author_facet | Kim, Soo Hee Chang, Hee Jin Kim, Dae Yong Park, Ji Won Baek, Ji Yeon Kim, Sun Young Park, Sung Chan Oh, Jae Hwan Yu, Ami Nam, Byung-Ho |
author_sort | Kim, Soo Hee |
collection | PubMed |
description | PURPOSE: Tumor regression grade (TRG) is predictive of therapeutic response in rectal cancer patients after chemoradiotherapy (CRT) followed by curative resection. However, various TRG systems have been suggested, with subjective categorization, resulting in interobserver variability. This study compared the prognostic validity of four different TRG systems in order to identify the most ideal TRG system. MATERIALS AND METHODS: This study included 933 patients who underwent preoperative CRT and curative resection. Primary tumors alone were graded according to the American Joint Committee on Cancer (AJCC), Dworak, and Ryan TRG systems, and both primary tumors and regional lymph nodes were graded according to a modified Dworak TRG system. The ability of each TRG system to predict recurrence-free survival (RFS) and overall survival (OS) was analyzed using chi-square and C statistics. RESULTS: All four TRG systems were significantly predictive of both RFS and OS (p < 0.001 each), however none was a better predictor of prognosis than ypStage. Among the four TRGs, the mDworak TRG system was a better predictor of RFS and OS than the AJCC, Dworak, and Ryan TRG systems, and both the chi-square and C statistics were higher for the former, although the differences were not statistically significant. The combination of ypStage and the modified Dworak TRG better predicted RFS and OS than ypStage alone. CONCLUSION: The modified Dworak TRG system for evaluation of entire tumors including regional lymph nodes is a better predictor of survival than current TRG systems for evaluation of the primary tumor alone. |
format | Online Article Text |
id | pubmed-4946373 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Korean Cancer Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-49463732016-07-18 What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy? Kim, Soo Hee Chang, Hee Jin Kim, Dae Yong Park, Ji Won Baek, Ji Yeon Kim, Sun Young Park, Sung Chan Oh, Jae Hwan Yu, Ami Nam, Byung-Ho Cancer Res Treat Original Article PURPOSE: Tumor regression grade (TRG) is predictive of therapeutic response in rectal cancer patients after chemoradiotherapy (CRT) followed by curative resection. However, various TRG systems have been suggested, with subjective categorization, resulting in interobserver variability. This study compared the prognostic validity of four different TRG systems in order to identify the most ideal TRG system. MATERIALS AND METHODS: This study included 933 patients who underwent preoperative CRT and curative resection. Primary tumors alone were graded according to the American Joint Committee on Cancer (AJCC), Dworak, and Ryan TRG systems, and both primary tumors and regional lymph nodes were graded according to a modified Dworak TRG system. The ability of each TRG system to predict recurrence-free survival (RFS) and overall survival (OS) was analyzed using chi-square and C statistics. RESULTS: All four TRG systems were significantly predictive of both RFS and OS (p < 0.001 each), however none was a better predictor of prognosis than ypStage. Among the four TRGs, the mDworak TRG system was a better predictor of RFS and OS than the AJCC, Dworak, and Ryan TRG systems, and both the chi-square and C statistics were higher for the former, although the differences were not statistically significant. The combination of ypStage and the modified Dworak TRG better predicted RFS and OS than ypStage alone. CONCLUSION: The modified Dworak TRG system for evaluation of entire tumors including regional lymph nodes is a better predictor of survival than current TRG systems for evaluation of the primary tumor alone. Korean Cancer Association 2016-07 2015-10-22 /pmc/articles/PMC4946373/ /pubmed/26511803 http://dx.doi.org/10.4143/crt.2015.254 Text en Copyright © 2016 by the Korean Cancer Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Soo Hee Chang, Hee Jin Kim, Dae Yong Park, Ji Won Baek, Ji Yeon Kim, Sun Young Park, Sung Chan Oh, Jae Hwan Yu, Ami Nam, Byung-Ho What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy? |
title | What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy? |
title_full | What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy? |
title_fullStr | What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy? |
title_full_unstemmed | What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy? |
title_short | What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy? |
title_sort | what is the ideal tumor regression grading system in rectal cancer patients after preoperative chemoradiotherapy? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946373/ https://www.ncbi.nlm.nih.gov/pubmed/26511803 http://dx.doi.org/10.4143/crt.2015.254 |
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