What Is the Prognostic Value of (y)pT and TRG?

Chapter

Abstract

The different types of scoring systems for grading the response to preoperative chemoradiotherapy are summarized and compared also by explanatory tables. The authors present several grading scoring systems, ranging from three to five grades. The prognostic significance and the clinical impact of tumor regression grade are reported. TRG determination appears to be the logical complement to traditional pathologic TNM staging, and combining TRG and TNM appears to optimize the management of rectal cancers treated with preoperative chemoradiotherapy. As TRG defines the amount of residual cancer cells after neoadjuvant therapy, further investigations are mandatory in order to define the quality of neoplastic cells and their behavior, especially in patients without lymph node metastasis. Identification of factors, indicating a more aggressive phenotype and/or resistance toward chemoradiotherapy, may contribute to improve the prognostic value of TRG and to allow tailoring of treatment.

Abbreviations

CAP

College of American Pathologists

CRT

Chemoradiotherapy

CSS

Cancer-specific survival

DFS

Disease-free survival

m-RCRG

Modified version of rectal cancer regression grade

RCPath

Royal College of Pathologists

RCRG

Rectal cancer regression grade

TRG

Tumor regression grade

ypTNM

TNM staging after neoadjuvant therapy

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Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  1. 1.Department of PathologyUniversità Cattolica S.CuoreRomeItaly

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