Histopathological regression grading matches excellently with local and regional spread after neoadjuvant therapy of rectal cancer

被引:13
作者
Elezkurtaj, Sefer [1 ]
Moser, Lutz [2 ]
Budczies, Jan [1 ]
Mueller, Alice Josephine [3 ]
Blaeker, Hendrik [1 ]
Buhr, Heinz Johannes [3 ]
Dietel, Manfred [1 ]
Kruschewski, Martin [3 ]
机构
[1] Charite Univ Med Berlin, Inst Pathol, D-10117 Berlin, Germany
[2] Charite Univ Med Berlin, Klin & Hochsch Ambulanz Radioonkol & Strahlenther, D-12200 Berlin, Germany
[3] Charite Univ Med Berlin, Chirurg Klin & Hochsch Ambulanz 1, Klink Allgemein Gefass & Thoraxchirurg, D-12200 Berlin, Germany
关键词
Rectal cancer; Neoadjuvant therapy; Regression grading; LYMPH-NODE STATUS; COMPLETE PATHOLOGICAL RESPONSE; HIGH-DOSE CHEMORADIATION; PREOPERATIVE CHEMORADIOTHERAPY; TUMOR-REGRESSION; PROGNOSTIC VALUE; CLINICAL IMPACT; SURVIVAL; DISEASE; RADIOCHEMOTHERAPY;
D O I
10.1016/j.prp.2013.04.009
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Histopathological regression grading has been shown to predict outcome in chemoradiated rectal cancer. Lymph node spread is still considered the most important single prognostic parameter. Therefore, we investigated the association of regression grading with tumor spread in a single center retrospective cohort. 102 consecutive patients who had undergone neoadjuvant therapy for rectal adenocarcinoma were included. Surgery was performed, including total mesorectal excision. Pathological examination included UICC staging and Dworak's five-tier tumor regression grading. Histological complete response was achieved in 16.7% of cases. Dworak's regression grading and a simplified two tier scheme both correlated excellently with ypT, ypN and UICC stage. However, cases with poor histological response were strongly represented in ypN0. Tumor regression grading is a reliable method for assessment of response to neoadjuvant therapy, but the optimal cut-off for separating good and poor response remains to be established based on clinical outcome. (C) 2013 Elsevier GmbH. All rights reserved.
引用
收藏
页码:424 / 428
页数:5
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