Research Papers:
New tumor regression grade for rectal cancer after neoadjuvant therapy and radical surgery
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Abstract
Jun Li1, Hao Liu2, Junjie Hu3, Sai Liu4, Jie Yin5, Feng Du6, Jiatian Yuan1, Bo Lv1
1General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China
2General Surgery Department, 2nd Affiliated Hospital of Jilin University, Changchun, People's Republic of China
3Gastrointestinal Tumor Surgery, Hubei Cancer Hospital, Wuhan, People's Republic of China
4Surgical Department of Gastrointestinal Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
5General Surgery Department, Xuzhou Central Hospital, Xuzhou, People's Republic of China
6Internal Medicine-Oncology, Cancer Institute/Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
Correspondence to:
Jun Li, e-mail: [email protected]
Keywords: tumor regression grading, rectal cancer, neoadjuvant therapy
Received: August 03, 2015 Accepted: October 09, 2015 Published: October 19, 2015
ABSTRACT
In this retrospective study, we defined a new tumor regression grade (NTRG), which we used to evaluate the prognosis of patients with locally advanced rectal cancer who received neoadjuvant therapy and then underwent radical surgery between June 2004 and October 2011. Calculated as the TRG plus a lymph node score, the NTRG was determined for 347 patients: NTRG 0, 46 patients (13.3%); NTRG 1, 63 (18.2%); NTRG 2, 183 (52.7%); NTRG 3, 30 (8.6%); NTRG 4, 25 (7.2%). Among this group, 45 (97.8%) NTRG 0, 56 (88.9%) NTRG 1, 148 (80.9%) NTRG 2, 24 (66.7%) NTRG 3, and 10 (40.0%) NTRG 4 patients experienced 5-year disease-free survival. We also found that NTRG is significantly associated with 5-year local recurrence, distant metastasis and disease-free survival (P = 0.004, 0.007 and 0.039, respectively). The NTRG may thus be an independent prognostic factor for oncologic outcomes in rectal cancer patients after neoadjuvant therapy and radical surgery, but this conclusion must be validated in randomized trials.
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