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The prognostic value of grade of regression and oncocytic change in rectal adenocarcinoma treated with neo‐adjuvant chemoradiotherapy
Author(s) -
Roy Paromita,
Serra Stefano,
Kennedy Erin,
Chetty Runjan
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22073
Subject(s) - medicine , grading (engineering) , adenocarcinoma , pathological , t stage , gastroenterology , chemoradiotherapy , stage (stratigraphy) , colorectal cancer , carcinoma , oncology , overall survival , cancer , paleontology , civil engineering , engineering , biology
Background Pathological staging and regression grading may affect the clinical outcome in rectal carcinoma patients treated with neoadjuvant chemoradiation (NACRT). Oncocytic change (OC) has also been described in the residual tumor. This study assesses the correlation of degree of pathological response and OC with clinical outcome. Methods Seventy‐five cases of rectal adenocarcinoma undergoing NACRT followed by surgery were retrospectively analyzed for preoperative and post‐operative staging, degree of tumor response to NACRT using the Dworak Regression score (DR) and Tumor Regression Grading (TRG) systems, as well as the proportion of cells showing OC. These parameters were correlated with overall survival (OS) and disease‐free survival (DFS). Results Significant correlation was found between post‐operative T and N stage and OS ( P = 0.005 and 0.002, respectively); and post‐operative and preoperative T stage with DFS ( P = 0.002 and 0.02, respectively). Grouping patients by TRG scores (TRG1‐3 vs TRG4‐5) also proved to be a significant independent prognosticator for DFS ( P < 0.001). The DR score groups and OC (<35% vs. >35%) were not statistically significant predictors of clinical outcome. Conclusions Post‐NACRT T and N staging and the TRG system are important prognostic indicators. The presence and extent of OC needs to be better understood and further investigated. J. Surg. Oncol. 2012; 105:130–134. © 2011 Wiley Periodicals, Inc.