What Is the Prognostic Value of (y)pT and TRG?
The different types of scoring systems for grading the response to preoperative chemoradiotherapy are summarized and compared also by explanatory tables. The authors present several grading scoring systems, ranging from three to five grades. The prognostic significance and the clinical impact of tumor regression grade are reported. TRG determination appears to be the logical complement to traditional pathologic TNM staging, and combining TRG and TNM appears to optimize the management of rectal cancers treated with preoperative chemoradiotherapy. As TRG defines the amount of residual cancer cells after neoadjuvant therapy, further investigations are mandatory in order to define the quality of neoplastic cells and their behavior, especially in patients without lymph node metastasis. Identification of factors, indicating a more aggressive phenotype and/or resistance toward chemoradiotherapy, may contribute to improve the prognostic value of TRG and to allow tailoring of treatment.
College of American Pathologists
Modified version of rectal cancer regression grade
Royal College of Pathologists
Rectal cancer regression grade
Tumor regression grade
TNM staging after neoadjuvant therapy
- 4.Dhadda AS, Bessell EM, Scholefield J et al (2014) Mandard tumour regression grade, perineural invasion, circumferential resection margin and post-chemoradiation nodal status strongly predict outcome in locally advanced rectal cancer treated with preoperative chemoradiotherapy. Clin Oncol (R Coll Radiol) 26:197–202CrossRefGoogle Scholar
- 6.Edge SB (2010) Ajcc cancer staging manual. In: Edge SB, Byrd DR, Compton CC et al III (eds), 7th edn. Springer, New York/LondonGoogle Scholar
- 10.Loughrey MB, Quirke P, Shepherd NA (2014) The Royal College of Pathologists, Dataset for colorectal cancer histopathology reports (3rd edition): https://www.rcpath.org/resourceLibrary/dataset-for-colorectal-cancer-histopathology-reports--3rd-edition-.html
- 18.Sobin LH, Gospodarowicz MK, Wittekind C (2010) Tnm classification of malignant tumours, 7th edn. Wiley-Blackwell, OxfordGoogle Scholar
- 24.Vecchio FM, Barba MC, Gambacorta MA et al (2010) Pathologic tumor regression grade (trg) and 10-year outcomes in 502 patients with rectal cancer treated with preoperative therapy. Mod Pathol 23(Suppl):171Google Scholar
- 27.Williams GT, Quirke P, Shepherd NA (2007) Dataset for colorectal cancer (2nd edition) - Appendix C: Proforma for colorectal cancer resections. http://www.rcpath.org/resources/worddocs/G049ColorectalDatasetAppendixC-Sep07.doc