The prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer.

Hdl Handle:
http://hdl.handle.net/10147/335958
Title:
The prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer.
Authors:
Abdul-Jalil, K I
Affiliation:
Department of Medical Oncology, Beaumont Hospital, Our Lady of Lourdes Hospital, Drogheda and Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Surgery, Our Lady of Lourdes Hospital, Drogheda and Royal, College of Surgeons in Ireland, Dublin, Ireland.
Citation:
The prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer. 2014, 16 (1):O16-25 Colorectal Dis
Journal:
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
Issue Date:
Jan-2014
URI:
http://hdl.handle.net/10147/335958
DOI:
10.1111/codi.12439
PubMed ID:
24119076
Abstract:
To date, there is no uniform consensus on whether tumour regression grade (TRG) is predictive of outcome in rectal cancer. Furthermore, the lack of standardization of TRG grading is a major source of variability in published studies. The aim of this study was to evaluate the prognostic impact of TRG in a cohort of patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy (CRT). In addition to the Mandard TRG, we utilized four TRG systems modified from the Mandard TRG system and applied them to the cohort to assess which TRG system is most informative.; One-hundred and fifty-three patients with a T3/T4 and/or a node-positive rectal cancer underwent neoadjuvant 5-fluorouracil-based CRT followed by surgical resection.; Thirty-six (23.5%) patients achieving complete pathological response (ypCR) had a 5-year disease-free survival (DFS) rate of 100% compared with a DFS rate of 74% for 117 (76.5%) patients without ypCR (P = 0.003). The Royal College of Pathologists (RCPath) TRG best condenses the Mandard five-point TRG by stratifying patients into three groups with distinct 5-year DFS rates of 100%, 86% and 67%, respectively (P = 0.001). In multivariate analysis, pathological nodal status and circumferential resection margin (CRM) status, but not TRG, remained significant predictors of DFS (P = 0.002, P = 0.035 and P = 0.310, respectively).; Our findings support the notion that ypCR status, nodal status after neoadjuvant CRT and CRM status, but not TRG, are predictors of long-term survival in patients with locally advanced rectal cancer.
Language:
en
Keywords:
Adenocarcinoma/pathology; Chemoradiotherapy; Lymph Nodes/pathology; Neoadjuvant Therapy; Rectal Neoplasms/pathology
MeSH:
Adenocarcinoma; Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Chemoradiotherapy; Disease-Free Survival; Female; Fluorouracil; Humans; Lymph Node Excision; Lymph Nodes; Male; Middle Aged; Multivariate Analysis; Neoadjuvant Therapy; Neoplasm Staging; Prognosis; Proportional Hazards Models; Rectal Neoplasms; Remission Induction; Treatment Outcome; Tumor Burden; Young Adult
ISSN:
1463-1318
Ethical Approval:
N/A

Full metadata record

DC FieldValue Language
dc.contributor.authorAbdul-Jalil, K Ien_GB
dc.date.accessioned2014-11-21T14:43:03Z-
dc.date.available2014-11-21T14:43:03Z-
dc.date.issued2014-01-
dc.identifier.citationThe prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer. 2014, 16 (1):O16-25 Colorectal Dis-
dc.identifier.issn1463-1318-
dc.identifier.pmid24119076-
dc.identifier.doi10.1111/codi.12439-
dc.identifier.urihttp://hdl.handle.net/10147/335958-
dc.description.abstractTo date, there is no uniform consensus on whether tumour regression grade (TRG) is predictive of outcome in rectal cancer. Furthermore, the lack of standardization of TRG grading is a major source of variability in published studies. The aim of this study was to evaluate the prognostic impact of TRG in a cohort of patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy (CRT). In addition to the Mandard TRG, we utilized four TRG systems modified from the Mandard TRG system and applied them to the cohort to assess which TRG system is most informative.-
dc.description.abstractOne-hundred and fifty-three patients with a T3/T4 and/or a node-positive rectal cancer underwent neoadjuvant 5-fluorouracil-based CRT followed by surgical resection.-
dc.description.abstractThirty-six (23.5%) patients achieving complete pathological response (ypCR) had a 5-year disease-free survival (DFS) rate of 100% compared with a DFS rate of 74% for 117 (76.5%) patients without ypCR (P = 0.003). The Royal College of Pathologists (RCPath) TRG best condenses the Mandard five-point TRG by stratifying patients into three groups with distinct 5-year DFS rates of 100%, 86% and 67%, respectively (P = 0.001). In multivariate analysis, pathological nodal status and circumferential resection margin (CRM) status, but not TRG, remained significant predictors of DFS (P = 0.002, P = 0.035 and P = 0.310, respectively).-
dc.description.abstractOur findings support the notion that ypCR status, nodal status after neoadjuvant CRT and CRM status, but not TRG, are predictors of long-term survival in patients with locally advanced rectal cancer.-
dc.language.isoen-
dc.rightsArchived with thanks to Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Irelanden_GB
dc.subjectAdenocarcinoma/pathologyen_GB
dc.subjectChemoradiotherapyen_GB
dc.subjectLymph Nodes/pathologyen_GB
dc.subjectNeoadjuvant Therapyen_GB
dc.subjectRectal Neoplasms/pathologyen_GB
dc.subject.meshAdenocarcinoma-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAntimetabolites, Antineoplastic-
dc.subject.meshChemoradiotherapy-
dc.subject.meshDisease-Free Survival-
dc.subject.meshFemale-
dc.subject.meshFluorouracil-
dc.subject.meshHumans-
dc.subject.meshLymph Node Excision-
dc.subject.meshLymph Nodes-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshMultivariate Analysis-
dc.subject.meshNeoadjuvant Therapy-
dc.subject.meshNeoplasm Staging-
dc.subject.meshPrognosis-
dc.subject.meshProportional Hazards Models-
dc.subject.meshRectal Neoplasms-
dc.subject.meshRemission Induction-
dc.subject.meshTreatment Outcome-
dc.subject.meshTumor Burden-
dc.subject.meshYoung Adult-
dc.titleThe prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer.en_GB
dc.contributor.departmentDepartment of Medical Oncology, Beaumont Hospital, Our Lady of Lourdes Hospital, Drogheda and Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Surgery, Our Lady of Lourdes Hospital, Drogheda and Royal, College of Surgeons in Ireland, Dublin, Ireland.en_GB
dc.identifier.journalColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland-
dc.type.qualificationlevelN/Aen
cr.approval.ethicalN/Aen
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen

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