Tumor Regression Grade After Neoadjuvant Chemoradiation and Surgery for Low Rectal Cancer Evaluated by Multiple Correspondence Analysis: Ten Years as Minimum Follow-up

Mancini, Raffaello; Pattaro, Giada; Diodoro, Maria Grazia; Sperduti, Isabella; Garufi, Carlo; Stigliano, V.; Perri, Pasquale; Grazi, Gian Luca; Cosimelli, Maurizio

doi:10.1016/j.clcc.2017.06.004

Cited by 27 publications

(20 citation statements)

References 29 publications

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“…In this respect, researches suggested different boundaries. For the Mandard TRG, some studies supported that TRG 1-2 should be classified into responders, which was in accordance with our study [7,18,19], while some others believed that TRG 1-3 was better in distinguishing the prognosis [20][21][22]. For the Becker TRG, there were studies supporting the same consequence as ours [1,[23][24][25], while others suggested TRG 1-2 owned a better prognosis than TRG 3 [9,10,26,27].…”

Section: Discussionsupporting

confidence: 89%

Evaluation and Comparison of Predictive Value of Tumor Regression Grades according to Mandard and Becker in Locally Advanced Gastric Adenocarcinoma

et al. 2021

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Tumor regression grade (TRG) has been widely used in gastrointestinal carcinoma to assess pathological responses to neoadjuvant chemotherapy (NCT). There are various standards without a consensus, and it is still unclear which kind of system has better predictive value. This study aims to investigate and compare the predictive ability of the Mandard and Becker TRGs in patients with locally advanced gastric cancer. Materials and Methods A total of 290 patients with locally advanced gastric adenocarcinoma who underwent NCT and curative surgery were studied. Survival analysis for overall survival (OS) and diseasefree survival (DFS) were based on the Kaplan-Meier method and Cox proportional hazards method. Predictive values of TRGs and models were assessed by time-dependent receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), nomogram, and calibration curve. Results In multivariable analysis, the Mandard TRG was associated with OS (hazard ratio [HR], 1.806; p=0.026) and DFS (HR, 1.792; p=0.017). The Becker TRG was also related to OS (HR, 1.880; p=0.014) and DFS (HR, 1.919; p=0.006). The Mandard and Becker TRG AUCs for 5-year survival were 0.72 and 0.71, respectively. The whole models showed an increased predictive value, with AUCs of 0.85 and 0.86, respectively. There was no significant difference between the two TRGs and two models. Conclusion TRG was an independent predictor for survival, and there was no significant difference between these two systems.

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Section: Discussionsupporting

confidence: 89%

Evaluation and Comparison of Predictive Value of Tumor Regression Grades according to Mandard and Becker in Locally Advanced Gastric Adenocarcinoma

et al. 2021

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“…The diagnosis of mucinous adenocarcinoma was based on the pre-treatment biopsy specimen as mucin seen in the resection specimen may have been due to the effects of treatment. The Mandard tumor regression grading score was used to assess response to neoadjuvant chemoradiotherapy (14). For all cases identified we performed a cross check with our biobank to ensure that there was fresh frozen tissue available for both normal rectum and tumor.…”

Section: Patient Cohortmentioning

confidence: 99%

Mucinous Adenocarcinoma of the Rectum: A Whole Genome Sequencing Study

et al. 2020

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Introduction: Mucinous adenocarcinoma of the rectum is an infrequently encountered histological subtype that is associated with an impaired response to chemoradiotherapy and a worse overall prognosis. A genomic profile analysis of mucinous rectal tumors has not yet been performed. The aim of this study was to comprehensively describe the burden of somatic mutations and copy number variation as well as perform mutational signature and microbial analysis of an in-house collected cohort of mucinous adenocarcinoma of the rectum. Methods: Genomic DNA was extracted from 10 cases of mucinous rectal cancer and matched normal tissue. Whole genome sequencing (WGS) was carried out on these 10 cases and a comprehensive bioinformatic analysis was undertaken. Results: The average number of SNVs, InDels and SVs in the cohort was 16,600, 1,855, and 120, respectively. A single case was MSI-H. KRAS mutations were found in 70% of cases while TP53 was mutated in only 40% of cases. CNA gain was identified on chromosomes 7, 8, 12, 13, and 20 while CNA loss was found on chromosomes 4, 8, 17, and 18 corresponding to oncogenes and tumor suppressor genes, respectively. Overall mucinous rectal cancers are more likely to be MSI-H and to have KRAS, BRAF, and PIK3CA mutations when compared to rectal adenocarcinoma NOS. Microbial analysis demonstrated an abundance of Fusobacterium nucleatum in tumor samples compared to normal tissue. Conclusion: This study provides a detailed WGS analysis of 10 cases of mucinous rectal cancer. It demonstrates an important lesson in tumor biology in that histologically similar tumors can have extensive differences at the genomic level. This study is relevant as it raises important questions about the relationship between bacteria and malignancy.

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“…In rectal cancer the clinical stage at diagnosis is a factor for prognosis of survival to 5 years, being for stage II from 60% to 75% and for stage III from 40% to 60%. Treatment with neoadjuvant chemo-radiotherapy produces a wide range of responses in the tumour, the best responding patients having the better prognosis, above all those who achieve the pathologic complete response (pCR) [11][12][13]. There are a number of systems used to classify the responses, the Ryan system published in 2005 being that used by the American College of Pathologists (Table 1) [14].…”

Section: Introductionmentioning

confidence: 99%

Role of the complete pathological response in rectal cancer: Value as a prognostic factor

Caravaca¹,

Juez-Martel²,

De-Torres-Olombrada³

et al. 2018

Endoprosthetic Total Scapula Replacement Versus Suspension Arthroplasty Following Tumor Resection

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To study the effect of the pathologic complete response (pCR) on the survival of patients treated with surgery and neoadjuvant chemo-radiotherapy in locally advanced non-metastatic rectal carcinoma (LARC). Materials and methodology We underwent an observational retrospective analysis of cohorts. The recruitment was carried out by means of non-probabilistic consecutive inclusion of patients with rectal cancer treated between January 2009 and December 2016 with surgery and neoadjuvant chemo-radiotherapy. The patients recruited had been diagnosed with locally advanced non-metastatic rectal cancer. cT3-4 o N+. based on the American Joint Committee on Cancer (AJCC) 2010. with histological confirmation of adenocarcinoma and no treatment with induction chemotherapy. The pathologic response was calibrated in accordance with the Ryan system. Survival was calculated with multivariate Cox regression analysis Results Pathologic complete response was reached by 19.2% Patients. The disease free survival was significantly lower in the no pathologic complete response (HR 0.099. p value 0.025). The progression in the group of patients with pathological complete response occurred in only one patient and have local and distal component compared to 39 patients in no pCR 21.2% distant metastases and 3.8% locally relapse. Perineural invasion and adjuvant chemotherapy were also significatly associated with disease free survival Conclusions The pathological complete response is a good prognosis factor in patients treated with surgery and nCRT in LARC with distal and local relapse. Perineural invasion and adjuvant chemotherapy were also good prognostic factors.

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Tumor Regression Grade After Neoadjuvant Chemoradiation and Surgery for Low Rectal Cancer Evaluated by Multiple Correspondence Analysis: Ten Years as Minimum Follow-up

Cited by 27 publications

References 29 publications

Evaluation and Comparison of Predictive Value of Tumor Regression Grades according to Mandard and Becker in Locally Advanced Gastric Adenocarcinoma

Evaluation and Comparison of Predictive Value of Tumor Regression Grades according to Mandard and Becker in Locally Advanced Gastric Adenocarcinoma

Mucinous Adenocarcinoma of the Rectum: A Whole Genome Sequencing Study

Role of the complete pathological response in rectal cancer: Value as a prognostic factor

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