title: Prognosis of rectal carcinoma after multimodal treatment: ypTNM classification and tumor regression grading are essential.
abstract: OBJECTIVE
  The value of grading tumor regression after neoadjuvant therapy of rectal carcinoma was evaluated.
  
  
  METHODS
  Analysis was carried out using prospective data of 225 patients with rectal carcinoma treated by neoadjuvant radiochemotherapy followed by radical resection with curative intent. For the histological regression grading, the method of Dworak et al. (1997) was used with a slight modification.
  
  
  RESULTS
  After neoadjuvant radiochemotherapy, the most important prognostic factors are pathologically assessed circumferential resection margin, quality of surgery (plane of surgery), and the ypT and ypN classification. In addition, the histological regression grade of primary tumor and regional lymph nodes influence outcome, especially the local recurrence rate.
  
  
  CONCLUSIONS
  After neoadjuvant therapy, the histological tumor regression grading should be assessed. A regression grading system based on the proposals of Dworak et al. (1997) is recommended.
authors: Department of Surgery, Universitätsklinikum Erlangen, Postfach 2306, D 91012 Erlangen, Germany. paul.hermanek@uk-erlangen.de
authors: Paul
authors: P
authors: Hermanek
authors: Susanne
authors: S
authors: Merkel
authors: Werner
authors: W
authors: Hohenberger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000145:classification* / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000145:classification* / Q000473:pathology* / Q000628:therapy*