ArticleThe oncologist2021
College of American Pathologists Tumor Regression Grading System for Long-Term Outcome in Patients with Locally Advanced Rectal Cancer.
Article in The oncologist, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic utility of perineural invasion in individuals with rectal cancer receiving neoadjuvant chemoradiotherapy: a meta-analysis.Frontiers in oncology · 2026Pooled it
- High xCT expression indicates poor prognosis and chemoradiotherapy resistance in rectal cancer patients.Cancer cell international · 2026Article
- Predictive value of primary gross tumor volume measured by MRI in response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer.Journal of applied clinical medical physics · 2026Article
- The impact of neoadjuvant chemotherapy on safety and long-term survival in patients with locally advanced colon cancer.World journal of surgical oncology · 2026Article
- Upfront surgery versus preoperative chemoradiotherapy: a comparative survival analysis for stage II/III resectable rectal cancer.Annals of coloproctology · 2026Article
- Survival impact of radiotherapy for patients with de novo metastatic rectal cancer.Annals of coloproctology · 2026Article
- Case Report: Remarkable response to savolitinib plus chemotherapy and bevacizumab in second-line treatment of MET amplified colon cancer with liver metastasis.Frontiers in oncology · 2026Article
- The predictive value of multi-phase contrast-enhanced MRI for pathological complete response after neoadjuvant chemoradiotherapy in rectal cancer.Frontiers in oncology · 2026Article
- Prognostic Impact of Tumor Regression and Downstaging After Neoadjuvant Therapy in Rectal Cancer.Iranian journal of pathology · 2026Article
- Gut microbiota profile and response to neoadjuvant chemoradiotherapy in patients with rectal cancer: a systematic review.Translational gastroenterology and hepatology · 2026Review
- Clinical characteristics and survival outcomes of well-responders following definite comprehensive treatment in locally advanced rectal cancer.BMC cancer · 2025Article
- Arterial-phase mucosal linear enhancement as an indicator of pathological complete response after immunotherapy in pMMR/MSS locally advanced rectal cancer.La Radiologia medica · 2025Article
- Overcoming the Challenge: A Comprehensive Review of Neoadjuvant Treatment Resistance in Rectal Cancer.Journal of gastrointestinal cancer · 2025Review
- The impact of different neoadjuvant radiotherapy doses on survival outcomes and toxicity in patients with locally advanced rectal cancer.Radiation oncology (London, England) · 2025Article
- Predicting pathological response of resectable esophageal squamous cell carcinoma to neoadjuvant anti-PD-1 with chemotherapy using serum inflammation indexes.Scientific reports · 2025Article
- Predictors of Pathologic Non-response to Neoadjuvant Approaches in Locally Advanced Rectal Cancer.Annals of surgical oncology · 2025Article
- Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy.Oncology letters · 2025Article
- Serum metabolite levels identify incipient metastatic progression of rectal cancer.Communications medicine · 2025Article
- Correlation analysis of tertiary lymphoid structure parameters with the prognosis of patients with locally advanced rectal cancer after neoadjuvant chemotherapy: a retrospective study.World journal of surgical oncology · 2025Article
- Association of metabolic dysregulation with treatment response in rectal cancer patients undergoing chemoradiotherapy.BMC medical genomics · 2025Article
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27 authors.
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Abstract
backgroundThe National Comprehensive Cancer Network's Rectal Cancer Guideline Panel recommends American Joint Committee of Cancer and College of American Pathologists (AJCC/CAP) tumor regression grading (TRG) system to evaluate pathologic response to neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC). Yet, the clinical significance of the AJCC/CAP TRG system has not been fully defined. MATERIALS AND
methodsThis was a multicenter, retrospectively recruited, and prospectively maintained cohort study. Patients with LARC from one institution formed the discovery set, and cases from external independent institutions formed a validation set to verify the findings from discovery set. Overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were assessed by Kaplan-Meier analysis, log-rank test, and Cox regression model.
resultsThe discovery set (940 cases) found, and the validation set (2,156 cases) further confirmed, that inferior AJCC/CAP TRG categories were closely /ccorrelated with unfavorable survival (OS, DFS, LRFS, and DMFS) and higher risk of disease progression (death, accumulative relapse, local recurrence, and distant metastasis) (all p < .05). Significantly, pairwise comparison revealed that any two of four TRG categories had the distinguished survival and risk of disease progression. After propensity score matching, AJCC/CAP TRG0 category (pathological complete response) patients treated with or without adjuvant chemotherapy displayed similar survival of OS, DFS, LRFS, and DMFS (all p > .05). For AJCC/CAP TRG1-3 cases, adjuvant chemotherapy treatment significantly improved 3-year OS (90.2% vs. 84.6%, p < .001). Multivariate analysis demonstrated the AJCC/CAP TRG system was an independent prognostic surrogate.
conclusionAJCC/CAP TRG system, an accurate prognostic surrogate, appears ideal for further strategizing adjuvant chemotherapy for LARC. IMPLICATIONS FOR PRACTICE: The National Comprehensive Cancer Network recommends the American Joint Committee of Cancer and College of American Pathologists (AJCC/CAP) tumor regression grading (TRG) four-category system to evaluate the pathologic response to neoadjuvant treatment for patients with locally advanced rectal cancer; however, the clinical significance of the AJCC/CAP TRG system has not yet been clearly addressed. This study found, for the first time, that any two of four AJCC/CAP TRG categories had the distinguished long-term survival outcome. Importantly, adjuvant chemotherapy may improve the 3-year overall survival for AJCC/CAP TRG1-3 category patients but not for AJCC/CAP TRG0 category patients. Thus, AJCC/CAP TRG system, an accurate surrogate of long-term survival outcome, is useful in guiding adjuvant chemotherapy management for rectal cancer.
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