Yang Yufei, Luo Dakui, Zhang Ruoxin, Cai Sanjun, Li Qingguo, Li Xinxiang
Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Clin Colorectal Cancer. 2022 Jun;21(2):96-106. doi: 10.1016/j.clcc.2021.10.006. Epub 2021 Nov 14.
The prognostic value of tumor regression grade (TRG) in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy has been explored extensively. However, whether TRG is predictive of outcome in colon cancer following preoperative chemotherapy has not been reported.
A total of 276 colon cancer patients who had undergone preoperative chemotherapy and surgery in Fudan University Shanghai Cancer Center during the period March 2014 through November 2019 were recruited in this study. 113 (40.9%) and 163 (59.1%) patients were diagnosed with locally advanced colon cancer (LACC) and metastatic colon cancer (mCC) before preoperative chemotherapy, respectively. The TRG was divided into TRG0 (complete response), TRG1 (good response), TRG2 (moderate response), and TRG3 (poor response).
Of the 276 patients 4.0% were TRG0, 5.4% were TRG1, 29.3% were TRG2, 61.2% were TRG3. TRG0 and TRG1 or TRG0, TRG1 and TRG2 were combined to simplify analysis due to limited sample size. In entire cohort, the 3-year overall survival for TRG0-1, TRG2, and TRG3 groups were 80.0%, 68.8% and 43.3% (P = .003). In LACC cohort, TRG was not associated with patients' prognosis, which largely resulted from limited outcome events. In mCC cohort, the 3-year overall survival for TRG0-1, TRG2, and TRG3 groups were 74.3%, 62.8% to 28.1% (P<0.001). Multivariate analysis demonstrated that TRG was an independent prognostic factor for overall survival in both entire cohort and mCC cohort (TRG3 vs. TRG0-2).
TRG is a prognostic factor in predicting long-term outcomes of mCC patients treated with preoperative chemotherapy.
肿瘤退缩分级（TRG）在接受新辅助放化疗的局部晚期直肠癌患者中的预后价值已得到广泛研究。然而，术前化疗后TRG能否预测结肠癌的预后尚未见报道。
本研究纳入了2014年3月至2019年11月期间在复旦大学附属肿瘤医院接受术前化疗及手术的276例结肠癌患者。术前化疗前，分别有113例（40.9%）和163例（59.1%）患者被诊断为局部晚期结肠癌（LACC）和转移性结肠癌（mCC）。TRG分为TRG0（完全缓解）、TRG1（良好缓解）、TRG2（中度缓解）和TRG3（差的缓解）。
276例患者中，4.0%为TRG0，5.4%为TRG1，29.3%为TRG2，61.2%为TRG3。由于样本量有限，将TRG0和TRG1或TRG0、TRG1和TRG2合并以简化分析。在整个队列中，TRG0 - 1组、TRG2组和TRG3组的3年总生存率分别为80.0%、68.8%和43.3%（P = 0.003）。在LACC队列中，TRG与患者预后无关，这主要是由于结局事件有限。在mCC队列中，TRG0 - 1组、TRG2组和TRG3组的3年总生存率分别为74.3%、62.8%至28.1%（P < 0.001）。多因素分析表明，TRG是整个队列和mCC队列总生存的独立预后因素（TRG3与TRG0 - 2相比）。
TRG是预测术前化疗的mCC患者长期预后的一个预后因素。
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