Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
Background The prognostic value of tumor regression grade (TRG) after neoadjuvant chemoradiotherapy for rectal cancer is inconsistent in the literature. Both TRG and post-therapy lymph node (ypN) status could reflect the efficacy of neoadjuvant therapy. Here, we explored whether TRG combined with yp...
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Taylor & Francis Group
2025-01-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/08941939.2025.2449669 |
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| author | Dakui Luo Yajie Chen Zhouyu Luo Huangbo Gong Qingguo Li Xinxiang Li |
| author_facet | Dakui Luo Yajie Chen Zhouyu Luo Huangbo Gong Qingguo Li Xinxiang Li |
| author_sort | Dakui Luo |
| collection | DOAJ |
| description | Background The prognostic value of tumor regression grade (TRG) after neoadjuvant chemoradiotherapy for rectal cancer is inconsistent in the literature. Both TRG and post-therapy lymph node (ypN) status could reflect the efficacy of neoadjuvant therapy. Here, we explored whether TRG combined with ypN status could be a prognostic factor for MRI-based lymph node-positive (cN+) rectal cancer following neoadjuvant chemoradiotherapy.Methods 671 cN + rectal cancer patients who received neoadjuvant chemoradiotherapy followed by radical resection were enrolled. Patients were innovatively divided into three groups based on TRG and ypN status: TRG0-1N0, TRG2-3N0 or TRG0-1N+, TRG2-3N+. Kaplan–Meier method and log-rank test were used to compare the disease-free survival (DFS) and overall survival (OS) among three groups. Univariate and multivariate analyses were performed to explore the prognostic value of the modified TRG in cN + rectal cancer following neoadjuvant chemoradiotherapy.Results The mean duration of follow-up was 30.4 months. Significant survival differences were observed among the three groups. The 3-year DFS were 83.0%, 69.2% and 55.9%, respectively. The 5-year OS were 83.5%, 80.4% and 57.8%, respectively. TRG combined with ypN status was an independent predictor for both DFS and OS in multivariate analysis.Conclusion TRG combined with ypN status is a novel prognostic factor in cN + rectal cancer following neoadjuvant chemoradiotherapy, which assists clinicians make appropriate decisions regarding postoperative treatment and surveillance. |
| format | Article |
| id | doaj-art-0bac67b9fdf4461ab0d107190ded3e93 |
| institution | Kabale University |
| issn | 0894-1939 1521-0553 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj-art-0bac67b9fdf4461ab0d107190ded3e932025-01-09T09:12:43ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532025-01-0138110.1080/08941939.2025.2449669Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant ChemoradiotherapyDakui Luo0Yajie Chen1Zhouyu Luo2Huangbo Gong3Qingguo Li4Xinxiang Li5Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Emergency, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People’ s Hospital, Yancheng, Jiangsu, ChinaDepartment of Vascular Surgery, The Affiliated Wuxi People’s Hosptial of Nanjing Medical University, Wuxi Medical Center, Nanjing Medical University, Wuxi People’s Hospital, Wuxi, Jiangsu, ChinaDepartment of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, ChinaBackground The prognostic value of tumor regression grade (TRG) after neoadjuvant chemoradiotherapy for rectal cancer is inconsistent in the literature. Both TRG and post-therapy lymph node (ypN) status could reflect the efficacy of neoadjuvant therapy. Here, we explored whether TRG combined with ypN status could be a prognostic factor for MRI-based lymph node-positive (cN+) rectal cancer following neoadjuvant chemoradiotherapy.Methods 671 cN + rectal cancer patients who received neoadjuvant chemoradiotherapy followed by radical resection were enrolled. Patients were innovatively divided into three groups based on TRG and ypN status: TRG0-1N0, TRG2-3N0 or TRG0-1N+, TRG2-3N+. Kaplan–Meier method and log-rank test were used to compare the disease-free survival (DFS) and overall survival (OS) among three groups. Univariate and multivariate analyses were performed to explore the prognostic value of the modified TRG in cN + rectal cancer following neoadjuvant chemoradiotherapy.Results The mean duration of follow-up was 30.4 months. Significant survival differences were observed among the three groups. The 3-year DFS were 83.0%, 69.2% and 55.9%, respectively. The 5-year OS were 83.5%, 80.4% and 57.8%, respectively. TRG combined with ypN status was an independent predictor for both DFS and OS in multivariate analysis.Conclusion TRG combined with ypN status is a novel prognostic factor in cN + rectal cancer following neoadjuvant chemoradiotherapy, which assists clinicians make appropriate decisions regarding postoperative treatment and surveillance.https://www.tandfonline.com/doi/10.1080/08941939.2025.2449669Neoadjuvant CRTtumor regression gradelymph node statusrectal cancer |
| spellingShingle | Dakui Luo Yajie Chen Zhouyu Luo Huangbo Gong Qingguo Li Xinxiang Li Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy Journal of Investigative Surgery Neoadjuvant CRT tumor regression grade lymph node status rectal cancer |
| title | Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy |
| title_full | Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy |
| title_fullStr | Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy |
| title_full_unstemmed | Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy |
| title_short | Prognostic Value of Tumor Regression Grade Combined with Pathological Lymph Node Status in Initially Node-Positive Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy |
| title_sort | prognostic value of tumor regression grade combined with pathological lymph node status in initially node positive rectal cancer treated with neoadjuvant chemoradiotherapy |
| topic | Neoadjuvant CRT tumor regression grade lymph node status rectal cancer |
| url | https://www.tandfonline.com/doi/10.1080/08941939.2025.2449669 |
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