scholarly journals Metabolic tumor constitution is superior to tumor regression grading for evaluating response to neoadjuvant therapy of esophageal adenocarcinoma patients

2021 ◽  
Author(s):  
Achim Buck ◽  
Verena M. Prade ◽  
Thomas Kunzke ◽  
Annette Feuchtinger ◽  
Dino Kröll ◽  
...  
Keyword(s):  
Neoadjuvant Therapy ◽  
Esophageal Adenocarcinoma ◽  
Tumor Regression ◽  
Regression Grading

scholarly journals Examination of Tumor Regression Grading Systems in Breast Cancer Patients Who Received Neoadjuvant Therapy

2020 ◽  
Vol 26 (4) ◽  
pp. 2747-2754
Author(s):  
Anita Sejben ◽  
Renáta Kószó ◽  
Zsuzsanna Kahán ◽  
Gábor Cserni ◽  
Tamás Zombori
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Tumor Regression ◽  
Breast Cancer Patients ◽  
Regression Grading ◽  
Grading Systems

scholarly journals Objective assessment of tumor regression in post-neoadjuvant therapy resections for pancreatic ductal adenocarcinoma: comparison of multiple tumor regression grading systems

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yoko Matsuda ◽  
Satoshi Ohkubo ◽  
Yuko Nakano-Narusawa ◽  
Yuki Fukumura ◽  
Kenichi Hirabayashi ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Neoadjuvant Therapy ◽  
Patient Outcomes ◽  
Tumor Regression ◽  
Ductal Adenocarcinoma ◽  
Grading System ◽  
Tumor Spread ◽  
Prognostic Performance ◽  
Regression Grading ◽  
Grading Systems

Abstract Neoadjuvant therapy is increasingly used to control local tumor spread and micrometastasis of pancreatic ductal adenocarcinoma (PDAC). Pathology assessments of treatment effects might predict patient outcomes after surgery. However, there are conflicting reports regarding the reproducibility and prognostic performance of commonly used tumor regression grading systems, namely College of American Pathologists (CAP) and Evans’ grading system. Further, the M.D. Anderson Cancer Center group (MDA) and the Japan Pancreas Society (JPS) have introduced other grading systems, while we recently proposed a new, simple grading system based on the area of residual tumor (ART). Herein, we aimed to assess and compare the reproducibility and prognostic performance of the modified ART grading system with those of the four grading systems using a multicenter cohort. The study cohort consisted of 97 patients with PDAC who had undergone post-neoadjuvant pancreatectomy at four hospitals. All patients were treated with gemcitabine and S-1 (GS)-based chemotherapies with/without radiation. Two pathologists individually evaluated tumor regression in accordance with the CAP, Evans’, JPS, MDA and ART grading systems, and interobserver concordance was compared between the five systems. The ART grading system was a 5-tiered system based on a number of 40× microscopic fields equivalent to the surface area of the largest ART. Furthermore, the final grades, which were either the concordant grades of the two observers or the majority grades, including those given by the third observer, were correlated with patient outcomes in each system. The interobserver concordance (kappa value) for Evans’, CAP, MDA, JPS and ART grading systems were 0.34, 0.50, 0.65, 0.33, and 0.60, respectively. Univariate analysis showed that higher ART grades were significantly associated with shorter overall survival (p = 0.001) and recurrence-free survival (p = 0.005), while the other grading systems did not show significant association with patient outcomes. The present study revealed that the ART grading system that was designed to be simple and more objective has achieved high concordance and showed a prognostic value; thus it may be most practical for assessing tumor regression in post-neoadjuvant resections for PDAC.

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