Abstract
The different types of scoring systems for grading the response to preoperative chemoradiotherapy are summarized and compared also by explanatory tables. The author presents both the five-grade scoring systems (Mandard and Dworak) and the three-grade systems (Wheeler, Rodel, and others). 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. 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.
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Abbreviations
- CRT:
-
Chemoradiotherapy
- CSS:
-
Cancer-specific survival
- DFS:
-
Disease-free survival
- m-RCRG:
-
Modified version of rectal cancer regression grade
- RCPath:
-
Royal College of Pathologists
- RCRG:
-
Rectal cancer regression grade
- TRG:
-
Tumor regression grade
- ypTNM:
-
TNM staging after neoadjuvant therapy
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© 2012 Springer-Verlag Berlin Heidelberg
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Vecchio, F.M. (2012). What Is the Prognostic Value of TRG?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25005-7_33
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DOI: https://doi.org/10.1007/978-3-642-25005-7_33
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