Li Jun, Liu Hao, Hu Junjie, Liu Sai, Yin Jie, Du Feng, Yuan Jiatian, Lv Bo
General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
General Surgery Department, 2nd Affiliated Hospital of Jilin University, Changchun, People's Republic of China.
Oncotarget. 2015 Dec 8;6(39):42222-31. doi: 10.18632/oncotarget.6008.
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.
在这项回顾性研究中，我们定义了一种新的肿瘤消退分级（NTRG），用于评估2004年6月至2011年10月期间接受新辅助治疗后再行根治性手术的局部晚期直肠癌患者的预后。NTRG通过肿瘤消退分级（TRG）加上淋巴结评分计算得出，共纳入347例患者：NTRG 0级46例（13.3%）；NTRG 1级63例（18.2%）；NTRG 2级183例（52.7%）；NTRG 3级30例（8.6%）；NTRG 4级25例（7.2%）。在该组患者中，NTRG 0级45例（97.8%）、NTRG 1级56例（88.9%）、NTRG 2级148例（80.9%）、NTRG 3级24例（66.7%）以及NTRG 4级10例（40.0%）患者实现了5年无病生存。我们还发现，NTRG与5年局部复发、远处转移和无病生存显著相关（P值分别为0.004、0.007和0.039）。因此，NTRG可能是新辅助治疗和根治性手术后直肠癌患者肿瘤学结局的独立预后因素，但这一结论必须在随机试验中得到验证。
