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Tumor Regression Grade in Gastric Cancer After Preoperative Therapy
Naruhiko Ikoma1, Jeannelyn S Estrella2, Mariela Blum Murphy3
1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. nikoma@mdanderson.org.
Summary
Tumor regression grade (TRG) 3 in gastric cancer patients after neoadjuvant therapy indicates advanced ypStage and R1 resection, correlating with shorter overall survival due to ypN+ status.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- The 8th edition of the Cancer Staging Manual now includes post-neoadjuvant therapy (ypTNM) staging for gastric cancer.
- Tumor regression grade (TRG) assesses the response of primary tumors to preoperative therapy.
Purpose of the Study:
- To evaluate the utility of tumor regression grade (TRG) in predicting survival for gastric cancer patients treated with neoadjuvant therapy.
Main Methods:
- Retrospective review of 356 gastric adenocarcinoma patients who received preoperative chemotherapy or chemoradiation.
- TRG was classified based on viable tumor cells: 0 (complete response), 1 (≤2%), 2 (≤50%), and 3 (>50%).
Main Results:
- Higher TRG correlated with advanced ypT, ypN, ypM1, and R1 resection.
- TRG 3 was associated with significantly shorter overall survival (OS) compared to TRG 0-2 (p=0.015).
- TRG was not independently associated with OS on multivariable analysis after adjusting for ypN status.
Conclusions:
- In gastric cancer patients receiving neoadjuvant therapy, TRG 3 signifies advanced ypStage and R1 resection.
- The poorer survival in TRG 3 patients is primarily linked to advanced ypStage, particularly ypN+ status.
