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.
Keywords
Abbreviations:
PRCRT (preoperative chemoradiotherapy), TME (total mesorectal excision), TNM (tumor-node-metastasis), AJCC (American Joint Committee on Cancer), CAP (College of American Pathologists), TRG (Tumor Regression Grade), DFS (disease-free survival), OS (overall survival), CRM (circumferential resection margin), LVI (lymphovascular invasion), PNI (perineural invasion)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: February 10, 2022
Accepted:
February 7,
2022
Received in revised form:
January 28,
2022
Received:
December 9,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc.
