ArticleVirchows Archiv : an international journal of pathology2015
Prognostic value of tumor shrinkage versus fragmentation following radiochemotherapy and surgery for rectal cancer.
Article in Virchows Archiv : an international journal of pathology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Defining response to radiotherapy in rectal cancer using magnetic resonance imaging and histopathological scales.World journal of gastroenterology · 2016Pooled it
- Tumor regression pattern and distribution of residual tumor cells in potential candidates for local excision of rectal cancer: a prospective cohort study.Techniques in coloproctology · 2026Article
- MRI-detected tumor deposits in cT3 and cT4 rectal cancer following neoadjuvant chemoradiotherapy.European radiology · 2024Article
- Factors Associated With Racial and Ethnic Disparities in Locally Advanced Rectal Cancer Outcomes.JAMA network open · 2024Article
- Identification of radiologic and clinicopathologic variables associated with tumor regression pattern and distribution of cancer cells after short-course radiotherapy and consolidation chemotherapy in patients with rectal cancer.Frontiers in oncology · 2024Article
- Tumor regression pattern may impact the prognosis of rectal cancer patients with tumor regression grade 1 after neoadjuvant chemoradiotherapy.Gastroenterology report · 2024Article
- Rectal tumor fragmentation as a response pattern following chemoradiation.Journal of gastrointestinal oncology · 2022Article
- Shrinkage versus fragmentation response in neoadjuvantly treated oesophageal adenocarcinoma: significant prognostic relevance.Histopathology · 2022Article
- [Grading of tumor regression of gastrointestinal carcinomas after neoadjuvant therapy].Der Pathologe · 2022Review
- Evaluation and Predictive Factors of Complete Response in Rectal Cancer after Neoadjuvant Chemoradiation Therapy.Medicina (Kaunas, Lithuania) · 2021Review
- Objective response rate assessment in oncology: Current situation and future expectations.World journal of clinical oncology · 2020Review
- Tumor regression grading of gastrointestinal cancers after neoadjuvant therapy.Virchows Archiv : an international journal of pathology · 2018Review
- Monitoring neoadjuvant therapy responses in rectal cancer using multimodal nonlinear optical microscopy.Oncotarget · 2017Article
- Prognostic influence of histopathological regression patterns in rectal adenocarcinoma receiving neoadjuvant therapy.Journal of gastrointestinal oncology · 2017Article
- Tumor regression in rectal cancer after intensified neoadjuvant chemoradiation: a morphometric and clinicopathological study.World journal of surgical oncology · 2015Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Most patients with rectal cancer receive neoadjuvant radiochemotherapy (RCT), causing a variable decrease in tumor mass. We evaluated the prognostic impact of pathologic parameters reflecting tumor response to RCT, either directly or indirectly. Seventy-six rectal cancer patients receiving neoadjuvant RCT between 2006 and 2009 were included. We studied the association between disease-free survival (DFS) and the "classical" clinicopathologic features as well as tumor deposits, circumferential resection margin (CRM), Dworak regression grade, and tumor and nodal downstaging. Patients with tumor downstaging had a longer DFS (p = 0.05), indicating a more favorable prognosis when regression was accompanied by a decrease in tumor infiltrative depth, referred to as tumor shrinkage. Moreover, tumor downstaging was significantly associated with larger CRM and nodal downstaging (p = 0.02), suggesting that shrinkage of the primary tumor was associated with a decreased nodal tumor load. Higher Dworak grade did not correlate with tumor downstaging, nor with higher CRM or prolonged DFS. This implies that tumor mass decrease was sometimes due to fragmentation rather than shrinkage of the primary tumor. Lastly, the presence of tumor deposits was clearly associated with reduced DFS (p = 0.01). Assessment of tumor shrinkage after RCT via tumor downstaging and CRM is a good way of predicting DFS in rectal cancer, and shrinkage of the primary tumor is associated with a decreased nodal tumor load. Assessing regression based on the amount of tumor in relation to stromal fibrosis does not accurately discern tumor fragmentation from tumor shrinkage, which is most likely the reason why Dworak grade had less prognostic relevance.
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