Prognostic value of American Joint Committee on Cancer-tumor regression grading combined with ypTN staging in patients with locally advanced rectal cancer
10.3760/cma.j.issn.1004-4221.2017.10.008
- VernacularTitle:AJCC-TRG联合ypTN分期评价局部进展期直肠癌预后
- Author:
Jiawang WEI
1
;
Weiwei XIAO
;
Shaoyan XI
;
Hui CHANG
;
Qiaoxuan WANG
;
Liren LI
;
Huizhong ZHANG
;
Zhifan ZENG
;
Peirong DING
;
Yuanhong GAO
Author Information
1. 华南肿瘤学国家重点实验室 中山大学肿瘤防治中心放射治疗科
- Keywords:
Rectal neoplasms/neoadjuvant therapy;
Neoadjuvant therapy,radiotherapy;
Neoadjuvant therapy,drug;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2017;26(10):1147-1150
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prognostic value of American Joint Committee on Cancer-tumor regression grading ( AJCC-TRG) combined with ypTN stage in patients with locally advanced rectal cancer (LARC),who were treated with neoadjuvant chemoradiotherapy,and to identify the subgroups with the worst prognosis. Methods A total of 263 patients with LARC,including 176 males and 87 females,with a median age of 55 years,were admitted to Sun Yat-sen University Cancer Center from 2004 to 2012.All the patients received neoadjuvant chemoradiotherapy before surgery and underwent total mesorectal excision at 6 to 8 weeks after radiotherapy. All the surgical specimens were reevaluated according to the AJCC ( 7th edition)-TRG system and ypTN staging criteria. The prognostic prediction by TRG combined with ypTN was evaluated using survival analysis. The Kaplan-Meier method was used to calculate the rates of overall survival ( OS ) , disease-free survival ( DFS ) , local recurrence-free survival ( LRFS ) , and distant metastasis-free survival ( DMFS ) . The log-rank test was used for survival comparison and univariate prognostic analysis. Results The median follow-up was 601 months. The 5-year rates of OS, DFS, LRFS, and DMFS for all patients were 800%,750%,970%,and 810%,respectively. There were significant differences in OS, DFS,and DMFS between different ypT/TRG subgroups and different ypN/TRG subgroups (all P<005). ypT3-4/TRG 2-3 and ypN1-2/TRG 2-3 subgroups showed the worst prognosis. The 5-year rates of OS,DFS, and DMFS of the two subgroups were 669%/560%, 522%/414%, and 609%/460%, respectively. Conclusions A combination of AJCC-TRG system and ypTN staging can better predict the prognosis of LARC and identify the subgroups with the worst prognosis, which may provide a clinical guidance for postoperative individualized decision on adjuvant therapy for LARC.
