Oncology Department, Old Road Research Campus Building, Oxford, United Kingdom, OX3 7DQ.
J Clin Pathol. 2012 Oct;65(10):867-71. doi: 10.1136/jclinpath-2012-200958. Epub 2012 Jun 25.
Neoadjuvant chemoradiotherapy for locally advanced rectal cancer has been shown to decrease rates of local recurrence and more than double the rate of sphincter-preserving surgery. There is now compelling evidence that pathological complete response is an independent predictor of likelihood of local recurrence, distal metastases, disease-free and overall survival in locally advanced rectal cancer following neoadjuvant chemoradiotherapy. Pathological regression grading can therefore guide clinical decisions about salvage surgical strategies, adjuvant therapy and long-term surveillance. No universally recognised regression grading system currently exists for pathologists presented with resected tumour specimens following neoadjuvant chemoradiotherapy. The purpose of this review is to highlight the relevance of accurate tumour regression grading in achieving optimal clinical care for patients with rectal cancer.
新辅助放化疗治疗局部晚期直肠癌已被证实可以降低局部复发率，并使保肛手术的比例增加一倍以上。目前有强有力的证据表明，病理完全缓解是新辅助放化疗治疗局部晚期直肠癌后局部复发、远处转移、无病生存和总生存的独立预测因素。因此，病理性消退分级可以指导关于挽救性手术策略、辅助治疗和长期监测的临床决策。目前，对于接受新辅助放化疗后切除的肿瘤标本，病理学家没有普遍认可的回归分级系统。本综述的目的是强调准确的肿瘤消退分级对于实现直肠癌患者最佳临床治疗的重要性。
