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Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas: A summary of 480 cases.
Ann. Surg. 253, 934-939 (2011)
OBJECTIVE: An increasing number of patients with locally advanced gastric carcinomas (GC) are being treated with preoperative chemotherapy before surgery. BACKGROUND: Histopathological tumor regression may have an important prognostic impact in addition to the UICC-TNM classification system. METHODS: We evaluated the histopathological tumor regression in 480 surgical resection specimens of GC after neoadjuvant cisplatin-based chemotherapy, using an established system encompassing three tumor regression grades based on the estimation of the percentage of residual tumor tissue at the primary tumor site in relation to the macroscopically identifiable former tumor bed. Tumor regression was correlated to clinicopathological characteristics and patient survival. RESULTS: Of the patients in this study, 102 (21.2%) had complete or subtotal tumor regression (<10% residual tumor), 121 (25.2%) had partial tumor regression (10-50% residual tumor), and 257 (53.5%) had minimal or no regression (>50% residual tumor). Tumor regression was significantly associated with posttreatment tumor category (pT), lymph node status (pN), lymphatic invasion status (pL), and resection status (P < 0.001). Major histopathological regression was less frequent in tumors of the distal stomach and tumors of nonintestinal type (P = 0.003). Tumor regression (P = 0.009) and postoperative Lymph node status (P < 0.001) were independent prognostic factors for survival in a multivariate analysis of tumor regression, ypT/N/L category, resection status, grading and Lauren´s classification. CONCLUSIONS: Assessment of histological tumor regression after preoperative chemotherapy in GC provides objective and highly valuable prognostic information in addition to posttherapeutic lymph node status. A standardized tumor regression grading system should be implemented in pathological reports of these tumors.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Early metabolic-response; Phase-II trial; Preoperative chemoradiation; Gastroesophageal junction; Esophagogatric cancer; Pathological response; Follow-up; Carcinoma; Therapy; Chemoradiotherapy
ISSN (print) / ISBN
0003-4932
e-ISSN
1528-1140
Zeitschrift
Annals of Surgery
Quellenangaben
Band: 253,
Heft: 5,
Seiten: 934-939
Verlag
Wolters Kluwer Health
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Pathology (PATH)