Associations of tumor regression grade with outcomes in patients with locally advanced rectal cancer treated with preoperative two-week course of radiotherapy

Yong-Heng Li; Jin-Luan Li; Xiang-Gao Zhu; Jun-Yan He; Li-Mei Lin; Xiao-Yi Lin; Li-Rui Tang; Yong Cai

doi:10.18632/oncotarget.22118

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Research Papers:

Associations of tumor regression grade with outcomes in patients with locally advanced rectal cancer treated with preoperative two-week course of radiotherapy

Yong-Heng Li, Jin-Luan Li, Xiang-Gao Zhu, Jun-Yan He, Li-Mei Lin, Xiao-Yi Lin, Li-Rui Tang and Yong Cai _

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Oncotarget. 2017; 8:100165-100175. https://doi.org/10.18632/oncotarget.22118

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Abstract

Yong-Heng Li1,*, Jin-Luan Li2,*, Xiang-Gao Zhu1, Jun-Yan He3, Li-Mei Lin4, Xiao-Yi Lin5, Li-Rui Tang2 and Yong Cai1

1Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education /Beijing), Peking University Cancer Hospital & Institute, Beijing, China

2Departments of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China

3Department of Biochemistry and Molecular Biology, University of South China, Hengyang, China

4Affiliated Xiamen First Hospital of Xiamen University, Xiamen, China

5Xiamen Humanity Hospital, Xiamen, China

*These authors contributed equally to this work

Correspondence to:

Yong Cai, email: [email protected]

Keywords: tumor regression grade; two-week course; radiotherapy; rectal cancer; prognosis

Received: August 13, 2017 Accepted: September 22, 2017 Published: October 26, 2017

ABSTRACT

Purpose: Studies concerning tumor regression grade (TRG) after two-week course of radiotherapy (RT) are limited. We tried to assess associations of TRG and outcomes in patients with locally advanced rectal cancer (LARC) treated with preoperative two-week course of RT.

Methods:356 consecutive LARC patients were retrospectively assessed. Patients with complete/intermediate (TRG1-3) and poor (TRG4-5) regressions were compared for overall survival (OS), disease-free survival (DFS) and metastasis-free survival (MFS).

Results: By univariate analysis, pretreatment and postoperative factors including TNM stages, ypT, ypN, surgical procedure, pathological grade, and TRG impacted survival outcomes. Complete/intermediate regressions (TRG1-3) had significantly improved survival outcomes compared with poor ones (TRG4-5) (5y-OS, 85.8% vs. 65.8%, P=0.001; 5y-DFS, 76.0% vs. 53.7%, P<0.001; 5y-MFS, 84.2% vs. 66.7%, P<0.001). Multivariate analysis showed that ypN (P<0.001) and pathological grade (P=0.018) were the most important independent prognostic factors for DFS. ypT (P=0.014) and ypN (P=0.001) were the independent prognostic factors for MFS. Meanwhile, ypT (P=0.009), ypN (P=0.001), surgical procedure (p=0.001), and TRG (p=0.019) were the independent prognostic factors for OS.

Conclusions:Complete/intermediate TRG regressions had a more favorable prognosis than the poor group. When treated with preoperative two-week course of RT; ypT, ypN, surgical procedure, and TRG seem to affect OS.

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Research Papers:

Associations of tumor regression grade with outcomes in patients with locally advanced rectal cancer treated with preoperative two-week course of radiotherapy

Abstract