Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer : a cross sectional multicentric experience
Germani, Paola (Department of General Surgery, Academic Hospital of Trieste, Strada di Fiume 447, Trieste, Italy)
Di Candido, Francesca (Humanitas Research Hospital (Itàlia))
Léonard, Daniel (Université Catholique de Louvain (UCL))
Cuicchi, Dajana (Alma Mater Studiorum University of Bologna)
Elmore, Ugo (Vita e Salute University)
Allaix, Marco Ettore (University of Torino)
Barbieri, Vittoria Pia (Cardinale Panico di Tricase Hospital, Lecce)
D'Allens, Laura (Cantonal Hospital Winterthur)
Faes, Seraina (Lausanne University Hospital)
Milani, Marika (Fondazione IRCCS Policlinico San Matteo)
Caputo, Damiano (University Campus-Biomedico Roma)
Martinez, Carmen (Institut d'Investigació Biomèdica Sant Pau)
Grosek, Jan (University Medical Centre Ljubljana)
Caracino, Valerio (Ospedale Santo Spirito)
Christou, Niki (Geneva University Hospitals (Suïssa))
Roodbeen, Sapho X. (University of Amsterdam)
Bracale, Umberto (Federico II University)
Wildeboer, Aurelia (Maastricht University Medical Centre)
Usai, Antonella (Regional Hospital "U. Parini", Aosta)
Benedetti, Michele ("C. E G. Mazzoni" Hospital, Ascoli Piceno)
Balani, Alessandro (San Polo Hospital, Monfalcone)
Piccinni, Giuseppe (Santa Maria Hospital GVM Care and Research)
Catarci, Marco ("C. E G. Mazzoni" Hospital, Ascoli Piceno)
Millo, Paolo (Regional Hospital "U. Parini", Aosta)
Bouvy, Nicole (Maastricht University Medical Centre)
Corcione, Francesco (Federico II University)
Hompes, Roel (Amsterdam UMC, University of Amsterdam)
Ris, Frédéric (Geneva University Hospitals (Suïssa))
Basti, Massimo (Ospedale Santo Spirito)
Tomazic, Ales (University Medical Centre Ljubljana)
Targarona, Eduardo M. (Institut d'Investigació Biomèdica Sant Pau)
Coppola, Alessandro (University Campus-Biomedico Roma)
Pietrabissa, Andrea (Fondazione IRCCS Policlinico San Matteo)
Hahnloser, Dieter (Lausanne University Hospital)
Adamina, Michel (Cantonal Hospital Winterthur)
Viola, Massimo (Cardinale Panico di Tricase Hospital, Lecce)
Morino, Mario (University of Torino)
Rosati, Riccardo (Vita e Salute University)
Poggioli, Gilberto (Alma Mater Studiorum University of Bologna)
Kartheuser, Alex (Université Catholique de Louvain (UCL))
Spinelli, Antonino (Humanitas Research Hospital (Itàlia))
de Manzini, Nicolò (Academic Hospital of Trieste)
Universitat Autònoma de Barcelona

Fecha:	2021
Resumen:	Pre-operative chemoradiotherapy (CRT) followed by surgical resection is still the standard treatment for locally advanced low rectal cancer. Nowadays new strategies are emerging to treat patients with a complete response to pre-operative treatment, rendering the optimal management still controversial and under debate. The primary aim of this study was to obtain a snapshot of tumor regression grade (TRG) distribution after standard CRT. Second, we aimed to identify a correlation between clinical tumor stage (cT) and TRG, and to define the accuracy of magnetic resonance imaging (MRI) in the restaging setting. Between January 2017 and June 2019, a cross sectional multicentric study was performed in 22 referral centers of colon-rectal surgery including all patients with cT3-4Nx/cTxN1-2 rectal cancer who underwent pre-operative CRT. Shapiro-Wilk test was used for continuous data. Categorical variables were compared with Chi-squared test or Fisher's exact test, where appropriate. Accuracy of restaging MRI in the identification of pathologic complete response (pCR) was determined evaluating the correspondence with the histopathological examination of surgical specimens. In the present study, 689 patients were enrolled. Complete tumor regression rate was 16. 9%. The "watch and wait" strategy was applied in 4. 3% of TRG4 patients. A clinical correlation between more advanced tumors and moderate to absent tumor regression was found (p = 0. 03). Post-neoadjuvant MRI had low sensibility (55%) and high specificity (83%) with accuracy of 82. 8% in identifying TRG4 and pCR. Our data provided a contemporary description of the effects of pre-operative CRT on a large pool of locally advanced low rectal cancer patients treated in different colon-rectal surgical centers.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Rectal cancer ; Pathologic complete response ; Neoadjuvant therapy ; Tumor regression grade
Publicado en:	Updates in Surgery, Vol. 73 (april 2021) , p. 1795-1803, ISSN 2038-3312

DOI: 10.1007/s13304-021-01044-0
PMID: 33818750

9 p, 650.9 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
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