Abstract 261P
Background
Accurate assessment of tumor regression grade (TRG) following neoadjuvant chemoradiotherapy (nCRT) is crucial for predicting prognosis and guiding treatment strategies in locally advanced rectal cancer (LARC). This study aimed to investigate the relationship between TRG, clinical factors, and patient outcomes after nCRT.
Methods
A retrospective analysis was conducted on patients with 129 LARC patients who underwent nCRT followed by surgery at a single tertiary care center from January 2019 to December 2022. Patient demographics, clinical characteristics, treatment variables, and histopathological data were collected. The grade of TRG was based on the extent of primary tumor replaced by fibrosis. Univariate and multivariate analyses were performed to identify factors influencing TRG and its association with disease-free survival (DFS).
Results
Of the 129 eligible patients, median follow-up time was 24 months, among whom 29 patients (22.48%) achieved TRG0, whereas 22 patients (17.05%) showed TRG3. TRG1 and TRG2 were both found in 37 patients (28.7%). Clinicopathologic factors that were related to TRG included baseline carcinoembryonic antigen (CEA) level (P=0.001), clinical T stage (P=0.039), pathologic T stage (P<0.001) and pathologic lymph node status (P=0.002). In multivariable analyses, TRG remained an independent predictor of DFS (HR = 0.52; p < 0.043).
Conclusions
TRG serves as a valuable prognostic indicator in LARC patients post-nCRT. Understanding the factors influencing TRG can aid in optimizing treatment strategies and predicting patient outcomes. Further prospective studies are warranted to validate these findings and refine TRG assessment in clinical practice.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.