Tumor Regression Grade as a Prognostic Factor in Metastatic Colon Cancer Following Preoperative Chemotherapy
Tumor Regression Grade as a Prognostic Factor in Metastatic Colon Cancer Following Preoperative Chemotherapy
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肿瘤消退等级作为术前化疗后转移性结肠癌的预后因素
DOI：
10.1016/j.clcc.2021.10.006
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发表时间：
2022-05-23
影响因子：
3.4
通讯作者：
Li, Xinxiang
中科院分区：
文献类型：
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作者：
Yang, Yufei;Luo, Dakui;Li, Xinxiang
本研究旨在探讨肿瘤消退分级对结肠癌的预后价值。共招募了我院276例结肠癌患者。我们发现肿瘤消退等级与转移性结肠癌的预后相关，而与局部晚期结肠癌的预后无关。背景：肿瘤消退等级（TRG）在局部晚期直肠癌患者接受新辅助放化疗治疗的预后价值已被广泛探讨。然而，TRG是否是结肠癌术前化疗后的预后预测尚未报道。材料与方法：本研究共招募了2014年3月至2019年11月期间在复旦大学上海肿瘤医院接受术前化疗和手术的276例结肠癌患者。术前化疗前分别有113例（40.9%）和163例（59.1%）患者被诊断为局部晚期结肠癌（LACC）和转移性结肠癌（mCC）。TRG分为TRG 0（完全缓解）、TRG 1（良好缓解）、TRG 2（中度缓解）和TRG 3（不良缓解）。结果：276例患者中，TRG 0占4.0%，TRG 1占5.4%，TRG 2占29.3%，TRG 3占61.2%。由于样本量有限，将TRG 0和TRG 1或TRG 0、TRG 1和TRG 2合并以简化分析。在整个队列中，TRG 0 -1、TRG 2和TRG 3组的3年总生存率分别为80.0%、68.8%和43.3%（P= 0.003）。在LACC队列中，TRG与患者的预后无关，这主要是由于有限的结局事件。在mCC队列中，TRG 0 -1、TRG 2和TRG 3组的3年总生存率分别为74.3%、62.8%和28.1%（P
The study aimed to explore the prognostic value of tumor regression grade in colon cancer. A total of 276 colon cancer patients in our hospital were recruited. We found that tumor regression grade was associated with prognosis of metastatic colon cancer instead of locally advanced colon cancer.Background: The prognostic value of tumor regression grade (TRG) in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy has been explored extensively. However, whether TRG is predictive of outcome in colon cancer following preoperative chemotherapy has not been reported. Materials and Methods: A total of 276 colon cancer patients who had undergone preoperative chemotherapy and surgery in Fudan University Shanghai Cancer Center during the period March 2014 through November 2019 were recruited in this study. 113 (40.9%) and 163 (59.1%) patients were diagnosed with locally advanced colon cancer (LACC) and metastatic colon cancer (mCC) before preoperative chemotherapy, respectively. The TRG was divided into TRG0 (complete response), TRG1 (good response), TRG2 (moderate response), and TRG3 (poor response). Results: Of the 276 patients 4.0% were TRG0, 5.4% were TRG1, 29.3% were TRG2, 61.2% were TRG3. TRG0 and TRG1 or TRG0, TRG1 and TRG2 were combined to simplify analysis due to limited sample size. In entire cohort, the 3-year overall survival for TRG0-1, TRG2, and TRG3 groups were 80.0%, 68.8% and 43.3% (P=.003). In LACC cohort, TRG was not associated with patients' prognosis, which largely resulted from limited outcome events. In mCC cohort, the 3-year overall survival for TRG0-1, TRG2, and TRG3 groups were 74.3%, 62.8% to 28.1% (P