AIMS: Neoadjuvant radiochemotherapy (RCT) followed by surgical resection is the treatment for locally advanced mid-rectal or low rectal cancer. The aim of this study was to evaluate postoperative histological prognostic factors in a series of surgical specimens after neoadjuvant RCT. METHODS AND RESULTS: One hundred and thirteen patients were included. Macroscopic and microscopic examinations were performed according to CAP recommendations, with additional criteria such as tumour budding, the presence of calcifications, and response to neoadjuvant therapy assessed according to Modified Rectal Cancer Regression Grade (m-RCRG). The 3-year disease-free survival (DFS) was 67.6%. In univariate analysis, ypTN stage, tumour budding, circumferential margin, invaded margin and vascular and perineural invasion were prognostic factors. In multivariate analysis, the presence of calcifications (P = 0.04) and an involved circumferential margin (P = 0.03) were the only independent factors for worse DFS. mRCRG was not correlated with DFS. Among the 50 m-RCRG1 tumours, DFS was better in ypT0 patients than in other ypT stages (P = 0.003). CONCLUSIONS: The presence of calcifications in the tumour bed is described for the first time as a prognostic factor in rectal cancer. The prognostic value of budding was demonstrated in this study after neoadjuvant RCT. ypT stage appears to be a more reliable predictor of oncological outcome than histological tumour regression grade, which needs to be standardized for better reproducibility.
AIMS: Neoadjuvant radiochemotherapy (RCT) followed by surgical resection is the treatment for locally advanced mid-rectal or low rectal cancer. The aim of this study was to evaluate postoperative histological prognostic factors in a series of surgical specimens after neoadjuvant RCT. METHODS AND RESULTS: One hundred and thirteen patients were included. Macroscopic and microscopic examinations were performed according to CAP recommendations, with additional criteria such as tumour budding, the presence of calcifications, and response to neoadjuvant therapy assessed according to Modified Rectal Cancer Regression Grade (m-RCRG). The 3-year disease-free survival (DFS) was 67.6%. In univariate analysis, ypTN stage, tumour budding, circumferential margin, invaded margin and vascular and perineural invasion were prognostic factors. In multivariate analysis, the presence of calcifications (P = 0.04) and an involved circumferential margin (P = 0.03) were the only independent factors for worse DFS. mRCRG was not correlated with DFS. Among the 50 m-RCRG1 tumours, DFS was better in ypT0 patients than in other ypT stages (P = 0.003). CONCLUSIONS: The presence of calcifications in the tumour bed is described for the first time as a prognostic factor in rectal cancer. The prognostic value of budding was demonstrated in this study after neoadjuvant RCT. ypT stage appears to be a more reliable predictor of oncological outcome than histological tumour regression grade, which needs to be standardized for better reproducibility.
Authors: Sun Mi Lee; Matthew H G Katz; Li Liu; Manonmani Sundar; Hua Wang; Gauri R Varadhachary; Robert A Wolff; Jeffrey E Lee; Anirban Maitra; Jason B Fleming; Asif Rashid; Huamin Wang Journal: Am J Surg Pathol Date: 2016-12 Impact factor: 6.394
Authors: Michelle Yang; Aseeb Ur Rehman; Chunlai Zuo; Christine E Sheehan; Edward C Lee; Jingmei Lin; Zijin Zhao; Euna Choi; Hwajeong Lee Journal: Cancer Med Date: 2016-05-11 Impact factor: 4.452
Authors: Tarkan Jäger; Daniel Neureiter; Mohammad Fallaha; Philipp Schredl; Tobias Kiesslich; Romana Urbas; Eckhard Klieser; Josef Holzinger; Felix Sedlmayer; Klaus Emmanuel; Adam Dinnewitzer Journal: Strahlenther Onkol Date: 2018-08-01 Impact factor: 3.621
Authors: Iryna Trotsyuk; Halina Sparschuh; Alice Josephine Müller; Konrad Neumann; Martin Kruschewski; David Horst; Sefer Elezkurtaj Journal: BMC Cancer Date: 2019-11-01 Impact factor: 4.430