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College of American Pathologists Tumor Regression Grading System for Long-term Outcome in Patients with Locally Advanced Rectal Cancer.

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收录情况： ◇ SCIE

作者：
HAI-YANG CHEN[a,b] * ; LI-LI FENG[a,b] * ; MING LI[c] * ; HUAI-QIANG JU[d] * ; YI DING[e] * ; MEI LAN[f] * ; SHU-MEI SONG[g] ; WEI-DONG HAN[h] ; LI YU[h] ; MING-BIAO WEI[a,b] ; XIAO-LIN PANG[a,b] ; FANG HE[a,b] ; SHUAI LIU[a,b] ; JIAN ZHENG[a,b] ; YAN MA[a,b] ; CHU-YANG LIN[i] ; PING LAN[b,j] ; MEI-JIN HUANG[b,j] ; YI-FENG ZOU[b,j] ; ZU-LI YANG[b,j] ; TING WANG[b,j] ; JIN-YI LANG[f] ; GUY R. ORANGIO[k] ; VITALIY POYLIN[l] ; JAFFER A AJANI[g] ; WEI-HU WANG[m,*b] ; XIANG-BO WAN[a,b,*a] ;
机构： [a]Department of Radiation Oncology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People’s Republicof China [b]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology,Guangzhou, People’s Republic of China [c]Department of Radiation Oncology, Beijing Hospital/ National Center of Gerontology, Beijing,People’s Republic of China [d]Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China,Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China [e]Department of Radiation Oncology,Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China [f]Department of RadiationOncology, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, RadiationOncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, People’s Republic of China [g]Department of Gastrointestinal MedicalOncology, the University of Texas MD Anderson Cancer Center, Houston, Texas, USA [h]Department of Medical Oncology, Sir Run RunShaw Hospital of College of Medicine Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China [i]Department of Clinical SkillsTraining Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China [j]Department ofGastrointestinal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China [k]Section of Colon and Rectal Surgery, LSU Department of Surgery, LSU School of Medicine, New Orleans, Louisiana, USA [l]Division ofColon & Rectum Surgery, Department of Surgery, Beth Israel Deaconess Medical Center of Harvard Medical School, Boston,Massachusetts, USA [m]Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department ofRadiation Oncology, Peking University Cancer Hospital and Institute, Beijing, People’s Republic of China
出处：
DOI： 10.1002/onco.13707
ISSN：

关键词： Tumor regression grade system • Locally advanced rectal cancer • Neoadjuvant treatments •Adjuvant chemotherapy • Survival outcome

摘要：
The National Comprehensive Cancer Network's Rectal Cancer Guideline Panel recommends American Joint Committee of Cancer and College of American Pathologists (AJCC/CAP) tumor regression grading (TRG) system to evaluate pathologic response to neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC). Yet, the clinical significance of the AJCC/CAP TRG system has not been fully defined. This was a multicenter, retrospectively recruited, and prospectively maintained cohort study. Patients with LARC from one institution formed the discovery set, and cases from external independent institutions formed a validation set to verify the findings from discovery set. Overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were assessed by Kaplan-Meier analysis, log-rank test, and Cox regression model. The discovery set (940 cases) found, and the validation set (2,156 cases) further confirmed, that inferior AJCC/CAP TRG categories were closely /ccorrelated with unfavorable survival (OS, DFS, LRFS, and DMFS) and higher risk of disease progression (death, accumulative relapse, local recurrence, and distant metastasis) (all p < .05). Significantly, pairwise comparison revealed that any two of four TRG categories had the distinguished survival and risk of disease progression. After propensity score matching, AJCC/CAP TRG0 category (pathological complete response) patients treated with or without adjuvant chemotherapy displayed similar survival of OS, DFS, LRFS, and DMFS (all p > .05). For AJCC/CAP TRG1-3 cases, adjuvant chemotherapy treatment significantly improved 3-year OS (90.2% vs. 84.6%, p < .001). Multivariate analysis demonstrated the AJCC/CAP TRG system was an independent prognostic surrogate. AJCC/CAP TRG system, an accurate prognostic surrogate, appears ideal for further strategizing adjuvant chemotherapy for LARC. The National Comprehensive Cancer Network recommends the American Joint Committee of Cancer and College of American Pathologists (AJCC/CAP) tumor regression grading (TRG) four-category system to evaluate the pathologic response to neoadjuvant treatment for patients with locally advanced rectal cancer; however, the clinical significance of the AJCC/CAP TRG system has not yet been clearly addressed. This study found, for the first time, that any two of four AJCC/CAP TRG categories had the distinguished long-term survival outcome. Importantly, adjuvant chemotherapy may improve the 3-year overall survival for AJCC/CAP TRG1-3 category patients but not for AJCC/CAP TRG0 category patients. Thus, AJCC/CAP TRG system, an accurate surrogate of long-term survival outcome, is useful in guiding adjuvant chemotherapy management for rectal cancer. © 2021 AlphaMed Press.

基金：
National Natural Science Foundation of China (81872188); National Natural Science Foundation for Young Scholars of China (81703080); International Center for Genetic Engineering and Biotechnology grant (CRP/CHN16–04_EC).
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2021]版：
大类 | 2 区 医学
小类 | 3 区 肿瘤学
最新[2023]版：
大类 | 2 区 医学
小类 | 2 区 肿瘤学
JCR分区：
出版当年[2021]版：
Q2 ONCOLOGY
最新[2023]版：
Q1 ONCOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者机构： [a]Department of Radiation Oncology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People’s Republicof China [b]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology,Guangzhou, People’s Republic of China
共同第一作者：
通讯作者：
通讯机构： [a]Department of Radiation Oncology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People’s Republicof China [b]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology,Guangzhou, People’s Republic of China [m]Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department ofRadiation Oncology, Peking University Cancer Hospital and Institute, Beijing, People’s Republic of China [*a]Department of Radiation Oncology, the Sixth Affiliated Hospital of Sun Yat-sen University, 26 YuanCun Er Heng Road, Guangzhou, Guangdong, 510655, People’s Republic of China [*b]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People’s Republic of China
推荐引用方式(GB/T 7714)：
HAI-YANG CHEN,LI-LI FENG,MING LI,et al.College of American Pathologists Tumor Regression Grading System for Long-term Outcome in Patients with Locally Advanced Rectal Cancer.[J].ONCOLOGIST.2021,26(5):E780-E793.doi:10.1002/onco.13707.
APA：
HAI-YANG CHEN,LI-LI FENG,MING LI,HUAI-QIANG JU,YI DING...&XIANG-BO WAN.(2021).College of American Pathologists Tumor Regression Grading System for Long-term Outcome in Patients with Locally Advanced Rectal Cancer..ONCOLOGIST,26,(5)
MLA：
HAI-YANG CHEN,et al."College of American Pathologists Tumor Regression Grading System for Long-term Outcome in Patients with Locally Advanced Rectal Cancer.".ONCOLOGIST 26..5(2021):E780-E793

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