2020
DOI: 10.1016/j.ctrv.2020.101964
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How to measure tumour response in rectal cancer? An explanation of discrepancies and suggestions for improvement

Abstract: Various methods categorize tumour response after neoadjuvant therapy, including down-staging and tumour regression grading. Response categories allow comparison of different treatments within clinical trials and predict outcome. A reproducible response categorization could identify subgroups with high or low risk for the most appropriate subsequent treatments, like watch and wait. Lack of standardization and interpretation difficulties currently limit the usability of these approaches. In this review we descri… Show more

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Cited by 64 publications
(57 citation statements)
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“…The histopathological study of proctectomy specimens post chemoradiotherapy may confirm the absence of atypical cells in the mucosa and submucosa, both of them replaced by fibrosis and persistence of residual tumor in the periphery at a muscular layer level itself or at extramural level, concluding the histopathological staging as ypT2 or ypT3. For these reasons, in our experience, a negative endoscopic biopsy after CRTn does not at all justify to rule out the need for radical resective surgery [28,29].…”
Section: Discussionmentioning
confidence: 76%
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“…The histopathological study of proctectomy specimens post chemoradiotherapy may confirm the absence of atypical cells in the mucosa and submucosa, both of them replaced by fibrosis and persistence of residual tumor in the periphery at a muscular layer level itself or at extramural level, concluding the histopathological staging as ypT2 or ypT3. For these reasons, in our experience, a negative endoscopic biopsy after CRTn does not at all justify to rule out the need for radical resective surgery [28,29].…”
Section: Discussionmentioning
confidence: 76%
“…Although WW has been evaluated as being viable and safe, the determination of response continues to be one of the major debate topics, as well as the eligibility criteria of the patients who could opt for this option, and the feasibility of a systematized follow-up that could allow access to the patients to a salvage surgery in the case of a change in their clinical condition [9,22,23,[25][26][27][28][29][30][31]. Because not always it is possible to detect the clinical complete responders some patients need to be operated and showed a complete pathological response (ypT0N0) like our patients in G2.…”
Section: Discussionmentioning
confidence: 99%
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“…In our study, tumour budding in the surgical resection after neoadjuvant therapy is also a sign of aggressive residual disease and worse outcome. Nagtegaal and colleagues show that tumour fragmentation after neoadjuvant therapy may be more important than tumour regression or tumour downstaging, a point which should be considered for future studies 18 …”
Section: Discussionmentioning
confidence: 99%
“…Most studies have used good responder and poor responder according to TRG as an evaluation method (9,20,21). Actually, TRG is subjective (22). The sensitivity to TNT was grouped according to tumor volume reduction rate on MRI and TRG of LARC following treatment with TNT.…”
Section: Discussionmentioning
confidence: 99%