Prognostic value of tumor regression grade (TRG) after oncological gastrectomy for gastric cancer.

Details

Serval ID
serval:BIB_30B8757C38CC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prognostic value of tumor regression grade (TRG) after oncological gastrectomy for gastric cancer.
Journal
Langenbeck's archives of surgery
Author(s)
Abboretti F., Mantziari S., Didisheim L., Schäfer M., Teixeira Farinha H.
ISSN
1435-2451 (Electronic)
ISSN-L
1435-2443
Publication state
Published
Issued date
27/06/2024
Peer-reviewed
Oui
Volume
409
Number
1
Pages
199
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Perioperative chemotherapy combined with surgical resection represent the gold standard in the treatment of locally advanced gastric cancer. The Mandard tumor regression score (TRG) is widely used to evaluate pathological response to neoadjuvant treatment. The aim of this study was to assess the prognostic value of TRG in terms of overall survival (OS) and disease-free (DFS).
Retrospective analysis of all consecutive patients who underwent oncological gastrectomy after neoadjuvant chemotherapy from January 2007 to December 2019 for gastric adenocarcinoma was performed. Based on their TRG status they were categorized into two groups: good responders (TRG 1-2) and poor responders (TRG 3-5). Subsequent multivariable analyses were conducted.
Seventy-four patients were included, whereby 15 (20.3%) were TRG 1-2. Neoadjuvant regimens for TRG 1-2 vs. TRG 3-5 were similar: MAGIC (53% vs. 39%), FLOT (40% vs. 36%), FOLFOX (7% vs. 15%, p = 0.462). Histologic types according to Lauren classification for TRG 1-2 vs. TRG 3-5 were: 13% vs. 29% intestinal, 53% vs. 44% diffuse and 34% vs. 27% indeterminate (p = 0.326). TRG 1-2 group exhibited significantly less advanced ypT (46% vs. 10%, p = 0.001) and ypN stages (66% vs. 37%, p = 0.008), alongside a diminished recurrence rate (20% vs. 42%, p = 0.111). The 3-year DFS was significantly better in this group (81% vs. 47%, p = 0.041) whereas the disparity in three-year OS (92% vs. 55%, p = 0.054) did not attain statistical significance.
TRG 1-2 was associated with less advanced ypT and ypN stage and better DFS compared to TRG 3-5 patients, without a significant impact on OS.
Keywords
Humans, Stomach Neoplasms/surgery, Stomach Neoplasms/pathology, Stomach Neoplasms/mortality, Gastrectomy, Male, Female, Retrospective Studies, Middle Aged, Aged, Prognosis, Neoadjuvant Therapy, Adenocarcinoma/surgery, Adenocarcinoma/pathology, Adenocarcinoma/mortality, Neoplasm Grading, Adult, Neoplasm Staging, Disease-Free Survival, Chemotherapy, Adjuvant, Survival Rate, Treatment Outcome, Gastric cancer, Neoadjuvant chemotherapy, Tumor regression grade
Pubmed
Open Access
Yes
Create date
05/07/2024 11:17
Last modification date
06/07/2024 7:06
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