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Treatment Resistant Cancers

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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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[Complete response after neoadjuvant therapy : How certain is the pathology?]

Iris Tischoff1, Andrea Tannapfel2

  • 1Institut für Pathologie, Ruhr-Universität Bochum, Universitätskliniken Bergmannsheil, Bürkle-de-la-Camp Platz 1, 44789, Bochum, Deutschland. iris.tischoff@rub.de.

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
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Summary

Tumor regression grading (TRG) systems assess residual tumor after neoadjuvant therapy, replacing WHO grading. Standardized TRG is needed for accurate tumor classification and treatment response evaluation.

Keywords:
HistopathologyMetastasesPrimary tumorTNM classificationTumor regression grading

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Area of Science:

  • Oncology
  • Pathology
  • Cancer Research

Background:

  • Histopathologic evaluation of tumors post-neoadjuvant therapy relies on tumor regression grading (TRG) systems.
  • TRG quantifies residual tumor proportion relative to the initial tumor size.
  • Current TRG systems are not uniform, varying by tumor type and grading scale (3- or 5-stage).

Purpose of the Study:

  • To highlight the importance of TRG in post-neoadjuvant therapy tumor evaluation.
  • To underscore the need for a standardized TRG system.
  • To define criteria for complete histopathological tumor regression.

Main Methods:

  • Histopathological examination of primary surgical specimens (tumor and lymph nodes).
  • Assessment of vital residual tumor cells.
  • Evaluation for distant metastases.

Main Results:

  • TRG systems are replacing the World Health Organization (WHO) grading system.
  • Histopathological work-up adheres to TNM classification criteria post-neoadjuvant therapy.
  • Complete regression requires absence of vital tumor cells and distant metastases.

Conclusions:

  • Standardization of TRG systems is crucial for consistent tumor classification.
  • Accurate TRG is essential for evaluating treatment efficacy.
  • The absence of vital tumor cells and distant metastases defines complete histopathological regression.