Impact of tumor regression grade on recurrence after preoperative chemoradiation and gastrectomy for gastric cancer.
J Surg Oncol
; 122(3): 422-432, 2020 Sep.
Article
en En
| MEDLINE
| ID: mdl-32462681
ABSTRACT
BACKGROUND AND OBJECTIVES:
It is unknown whether the degree of response to preoperative therapy correlates with locoregional recurrence (LR) or distant recurrence (DR) after resection of gastric cancer.METHODS:
Patients who underwent resection of gastric adenocarcinoma following chemotherapy and chemoradiation (1995-2015) were reviewed. The tumor regression grade (TRG) was defined by the percentage of viable tumor cells in the specimen (TRG0 = 0%; TRG1 = 1%-2%; TRG2 = 3%-50%; TRG3 ≥ 50%). The relationships among TRG, recurrence-free survival (RFS), LR, and DR were examined.RESULTS:
Two hundred forty-seven patients met the inclusion criteria (TRG0, 52 [21%]; TRG1, 49 [20%]; TRG2, 98 [40%]; TRG3, 48 [19%]). LR and DR occurred in 6.1% and 32.0% of patients, respectively. No patient with TRG0 experienced LR. R1 resection (6%-15%) and LR (6%-8%) rates were similar among TRG1-3 patients. R1 resection was associated with LR (hazard ratio [HR], 17.85; P < .001). ypN status (HR, 2.44; P = .004) and linitis plastica (HR, 2.90; P < .001) were associated with DR. TRG was not independently associated with RFS, LR, or DR.CONCLUSIONS:
TRG0 imparted excellent local control. However, TRG1-3 patients had similar R1 resection rates and therefore similar LR. DR is associated with ypN status and linitis plastica, not TRG.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Gástricas
/
Recurrencia Local de Neoplasia
Tipo de estudio:
Prognostic_studies
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
País como asunto:
America do norte
Idioma:
En
Año:
2020
Tipo del documento:
Article