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

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Multidisciplinary Management of Rectal Cancer

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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.

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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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Authors and Affiliations

  1. Department of Pathology, Università Cattolica S.Cuore, Largo F.Vito, 1, 00168, Rome, Italy

    Fabio M. Vecchio & Riccardo Ricci

Authors
  1. Fabio M. Vecchio
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  2. Riccardo Ricci
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Correspondence to Fabio M. Vecchio .

Editor information

Editors and Affiliations

  1. Dept. of Radiation Oncology, Università Cattolica S Cuore, Rome, Italy

    Vincenzo Valentini

  2. Head, Div. Clinical Oncology Research, University Clinic Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Sachsen-Anhalt, Germany

    Hans-Joachim Schmoll

  3. Department of Surgery, Leiden Univ Med Ctr, Leiden, The Netherlands

    Cornelis J. H. van de Velde

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Vecchio, F.M., Ricci, R. (2018). What Is the Prognostic Value of (y)pT and TRG?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43217-5_63

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  • DOI: https://doi.org/10.1007/978-3-319-43217-5_63

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43215-1

  • Online ISBN: 978-3-319-43217-5

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