An investigation into tumor regression grade as a parameter for locally advanced rectal cancer and 5-year overall survival rate

Supparerk Laohawiriyakamol; Wongsakorn Chaochankit; Worawit Wanichsuwan; Kanet Kanjanapradit; Teeranan Laohawiriyakamol

doi:10.3393/ac.2021.01011.0144

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자료유형: 학술저널

저자정보: Supparerk Laohawiriyakamol (Department of Surgery Faculty of Medicine Prince of Songkla University) Wongsakorn Chaochankit (Department of Surgery Faculty of Medicine Prince of Songkla University) Worawit Wanichsuwan (Department of Surgery Faculty of Medicine Prince of Songkla University) Kanet Kanjanapradit (Department Pathology Faculty of Medicine Prince of Songkla University) Teeranan Laohawiriyakamol (Department of Radiology Faculty of Medicine Prince of Songkla University)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.39 No.1

발행연도: 2023.2

수록면: 59 - 70 (12page)

DOI: 10.3393/ac.2021.01011.0144

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Purpose: The standard treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiation (nCRT) followed by surgery. Several parameters are associated with patient survival in LARC. One of these parameters is tumor regression grade (TRG); however, the significance of TRG remains controversial. In this study, we aimed to examine the correlations of TRG with 5-year overall (OS) and relapse-free survival (RFS) and identify other factors that influence the survival rates in LARC after nCRT followed by surgery. Methods: This retrospective study included 104 patients diagnosed with LARC who underwent nCRT followed by surgery at Songklanagarind Hospital from January 2010 to December 2015. All patients received fluoropyrimidine-based chemotherapy at a total dose of 45.0 to 50.4 Gy in 25 daily fractions. Tumor response was evaluated using the 5-tier Mandard TRG classification. TRG was categorized into good (TRG 1–2) and poor (TRG 3–5) responses. Results: TRG (classified by either the 5-tier classification system or the 2-group classification system) was not correlated with 5-year OS or RFS. The 5-year OS rates were 80.0%, 54.5%, 80.8%, and 67.4% in patients with TRG 1, 2, 3, and 4, respectively (P=0.22). Poorly differentiated rectal cancer and systemic metastasis were associated with poor 5-year OS. Intraoperative tumor perforation, poor differentiation, and perineural invasion were correlated with inferior 5-year RFS. Conclusion: TRG was probably not associated with either 5-year OS or RFS; however, poor differentiation and systemic metastasis were strongly associated with poor 5-year OS.

#Chemoradiotherapy #Neoadjuvant therapy #Rectal cancer #Survival

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