title: New tumor regression grade for rectal cancer after neoadjuvant therapy and radical surgery.
abstract: In this retrospective study, we defined a new tumor regression grade (NTRG), which we used to evaluate the prognosis of patients with locally advanced rectal cancer who received neoadjuvant therapy and then underwent radical surgery between June 2004 and October 2011. Calculated as the TRG plus a lymph node score, the NTRG was determined for 347 patients: NTRG 0, 46 patients (13.3%); NTRG 1, 63 (18.2%); NTRG 2, 183 (52.7%); NTRG 3, 30 (8.6%); NTRG 4, 25 (7.2%). Among this group, 45 (97.8%) NTRG 0, 56 (88.9%) NTRG 1, 148 (80.9%) NTRG 2, 24 (66.7%) NTRG 3, and 10 (40.0%) NTRG 4 patients experienced 5-year disease-free survival. We also found that NTRG is significantly associated with 5-year local recurrence, distant metastasis and disease-free survival (P = 0.004, 0.007 and 0.039, respectively). The NTRG may thus be an independent prognostic factor for oncologic outcomes in rectal cancer patients after neoadjuvant therapy and radical surgery, but this conclusion must be validated in randomized trials.
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: General Surgery Department, 2nd Affiliated Hospital of Jilin University, Changchun, People's Republic of China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Gastrointestinal Tumor Surgery, Hubei Cancer Hospital, Wuhan, People's Republic of China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Hu
authors.affiliation: Surgical Department of Gastrointestinal Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Sai
authors.initials: S
authors.lastname: Liu
authors.affiliation: General Surgery Department, Xuzhou Central Hospital, Xuzhou, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yin
authors.affiliation: Internal Medicine-Oncology, Cancer Institute/Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
authors.forename: Feng
authors.initials: F
authors.lastname: Du
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Jiatian
authors.initials: J
authors.lastname: Yuan
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Lv
mesh_terms: D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy*; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: neoadjuvant therapy; rectal cancer; tumor regression grading