Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer: a cross sectional multicentric experience.

Détails

ID Serval
serval:BIB_B1CA2AA6E808
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer: a cross sectional multicentric experience.
Périodique
Updates in surgery
Auteur(s)
Germani P., Di Candido F., Léonard D., Cuicchi D., Elmore U., Allaix M.E., Barbieri V.P., D'Allens L., Faes S., Milani M., Caputo D., Martinez C., Grosek J., Caracino V., Christou N., Roodbeen S.X., Bracale U., Wildeboer A., Usai A., Benedetti M., Balani A., Piccinni G., Catarci M., Millo P., Bouvy N., Corcione F., Hompes R., Ris F., Basti M., Tomazic A., Targarona E., Coppola A., Pietrabissa A., Hahnloser D., Adamina M., Viola M., Morino M., Rosati R., Poggioli G., Kartheuser A., Spinelli A., de Manzini N.
Collaborateur(s)
TRG Snapshot Study Group
Contributeur(s)
Bellio G., Iacuzzo C., Zucca A., Corleone P., Giudici F., Palmisano S., Carvello M., Remue C., Bachmann R., Lombard N., Pirlet C., Ryckx A., Massaron S., Pugliese L., Coppola R., Ferrari C., Castiglioni S., Ponte E., Concina S., Piveteau A., An Y., Cagnazzo E., Troian M.
ISSN
2038-3312 (Electronic)
ISSN-L
2038-131X
Statut éditorial
Publié
Date de publication
10/2021
Peer-reviewed
Oui
Volume
73
Numéro
5
Pages
1795-1803
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Pre-operative chemoradiotherapy (CRT) followed by surgical resection is still the standard treatment for locally advanced low rectal cancer. Nowadays new strategies are emerging to treat patients with a complete response to pre-operative treatment, rendering the optimal management still controversial and under debate. The primary aim of this study was to obtain a snapshot of tumor regression grade (TRG) distribution after standard CRT. Second, we aimed to identify a correlation between clinical tumor stage (cT) and TRG, and to define the accuracy of magnetic resonance imaging (MRI) in the restaging setting. Between January 2017 and June 2019, a cross sectional multicentric study was performed in 22 referral centers of colon-rectal surgery including all patients with cT3-4Nx/cTxN1-2 rectal cancer who underwent pre-operative CRT. Shapiro-Wilk test was used for continuous data. Categorical variables were compared with Chi-squared test or Fisher's exact test, where appropriate. Accuracy of restaging MRI in the identification of pathologic complete response (pCR) was determined evaluating the correspondence with the histopathological examination of surgical specimens.In the present study, 689 patients were enrolled. Complete tumor regression rate was 16.9%. The "watch and wait" strategy was applied in 4.3% of TRG4 patients. A clinical correlation between more advanced tumors and moderate to absent tumor regression was found (p = 0.03). Post-neoadjuvant MRI had low sensibility (55%) and high specificity (83%) with accuracy of 82.8% in identifying TRG4 and pCR.Our data provided a contemporary description of the effects of pre-operative CRT on a large pool of locally advanced low rectal cancer patients treated in different colon-rectal surgical centers.
Mots-clé
Chemoradiotherapy, Cross-Sectional Studies, Humans, Neoadjuvant Therapy, Neoplasm Staging, Rectal Neoplasms/diagnostic imaging, Rectal Neoplasms/surgery, Rectum/pathology, Treatment Outcome, Neoadjuvant therapy, Pathologic complete response, Rectal cancer, Tumor regression grade
Pubmed
Web of science
Open Access
Oui
Création de la notice
16/07/2021 11:18
Dernière modification de la notice
26/10/2021 5:38
Données d'usage