1. Prognostic Value of Mandard's Tumor Regression Grade (TRG) in Post Chemo-Radiotherapy Cervical Cancer.
- Author
-
Scaglione, Giulia, Arciuolo, Damiano, Travaglino, Antonio, Santoro, Angela, Angelico, Giuseppe, Spadola, Saveria, Inzani, Frediano, D'Alessandris, Nicoletta, Raffone, Antonio, Fulgione, Caterina, Padial Urtueta, Belen, Sfregola, Stefania, Valente, Michele, Addante, Francesca, d'Amati, Antonio, Cianfrini, Federica, Piermattei, Alessia, Pedone Anchora, Luigi, Scambia, Giovanni, and Ferrandina, Gabriella
- Subjects
PROGNOSIS ,CERVICAL cancer ,PROGRESSION-free survival ,CHEMORADIOTHERAPY ,TUMOR grading ,RECTAL cancer - Abstract
In locally advanced cervical cancer (LACC), definitive chemo-radiotherapy is the standard treatment, but chemo-radiotherapy followed by surgery could be an alternative choice in selected patients. We enrolled 244 patients affected by LACC and treated with CT-RT followed by surgery in order to assess the prognostic role of the histological response using the Mandard scoring system. Results: A complete pathological response (TRG 0) was observed in 118 patients (48.4%), rare residual cancer cells (TRG2) were found in 49 cases (20.1%), increased number of cancer cells but fibrosis still predominating (TRG3) in 35 cases (14.3%), and 42 (17.2%) were classified as non-responders (TRG4–5). TRG was significantly associated with both OS (p < 0.001) and PFS (p < 0.001). The survival curves highlighted two main prognostic groups: TRG1-TRG2 and TRG3-TRG4–5. Main responders (TRG1–2) showed a 92% 5-year overall survival (5y-OS) and a 75% 5-year disease free survival (5y-DFS). Minor or no responders showed a 48% 5y-OS and a 39% 5y-DFS. The two-tiered TRG was independently associated with both DFS and OS in Cox regression analysis. Conclusion. We showed that Mandard TRG is an independent prognostic factor in post-CT/RT LACC, with potential benefits in defining post-treatment adjuvant therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF