Correlative Significance of Tumor Regression Grade and ypT Category in Patients Undergoing Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer |
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| Affiliation: | 1. Division of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;2. Department of Pathology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea;1. Vanderbilt-Ingram Cancer Center, Nashville, TN;2. Department of Medicine (Hematology & Oncology), Vanderbilt University Medical Center; Nashville, TN;3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN;4. Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN;5. Department of Surgical Pathology, Duke University Health System, Durham, NC;1. Hôpital Européen Georges Pompidou, Université de Paris, Paris, France;2. Centre Léon Bérard, Lyon, France;3. Hopital Saint Antoine, Paris, France;4. Private Hospital Jean Mermoz, Lyon, France;5. Methodology and Quality of Life in Oncology Unit, Besançon University Hospital, Besançon, France;6. Département d''Oncologie Médicale CHU Poitiers, Poitiers, France;7. University Hospital Pitie Salpetriere APHP, Paris, France;8. CHU Robert Debré, Reims, France;9. Cochin University Hospital, Paris, France;10. Centre Antoine-Lacassagne, Nice, France;11. CH La Rochelle, La Rochelle, France;12. Département d''Hépato-Gastro-entérologie, CHU de Poitiers, Poitiers, France;1. Department of Tumor Radiotherapy, The Second Affiliated Hospital of Zhengzhou University, The Second Affiliated Hospital of Zhengzhou University. China;2. Medical Oncology Department. Catalan Institute of Oncology: Institut Catala d''Oncologia Badalona, Barcelona, Spain |
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| Abstract: | Background: In patients with locally advanced rectal cancer, the treatment response to preoperative chemoradiotherapy (PRCRT) varies, and the ypT stage may change as a result of tumor shrinkage. The purpose of this study was to evaluate the correlative significance and determine the prognostic value of tumor regression grade and ypT category staging systems.Materials and Methods: This retrospective observational study was conducted in a tertiary center. A total of 1240 patients with rectal cancer who underwent curative resection after PRCRT between January 2007 and December 2016 were consecutively included.Results: A significant association was found between the American Joint Committee on Cancer/College of American Pathology tumor regression grading system and ypT category, indicating a potential correlation between worse tumor regression grade and more advanced T stage (Cramer's V = 0.255, P < .001). The ypT stage and tumor regression grade were independent predictors of each other (P < .001). The good response group (tumor regression grades 0-1) had significantly higher 5-year disease-free survival (85.5% vs. 68.2%, P < .001) and overall survival (92.1% vs. 81.0%, P < .001) rates than the poor response group (tumor regression grades 2-3). However, the ypT and ypN categories were the most important independent prognostic factors for disease-free and overall survival.Conclusions: Tumor regression grade and ypT category were significantly correlated. Although tumor regression grade alone is not definitive, it is closely related to the ypT stage and impacts oncologic outcomes. These findings should be taken into consideration when stratifying the prognosis of patients undergoing PRCRT. |
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| Keywords: | Tumor response |
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