Tumor regression grade and survival after neoadjuvant treatment in gastro-esophageal cancer: A meta-analysis of 17 published studies

Lymph node regression after neoadjuvant chemotherapy: A predictor of survival in gastric cancer

“…However, few studies included only stomach tumors. When evaluated separately, the survival benefit is more evident in esophageal or junction tumors, with no significant advantage in gastric lesions …”

“…Some believe that a marked histological response to treatment indicates better survival, while others deny its role as a prognostic marker . Histologic changes in response to the nCMT are currently classified by TRG, which is has been associated as prognostic factor in some types of cancer . Since there are different TRG systems, to allow better reproducibility we evaluated the response based on the percentage of viable tumor cells and defined two response groups.…”

“…In contrast, some claim that tumor regression correlates with survival. A meta‐analysis including 3145 patients showed that major pathologic response (pCR or few residual cells) was associated with better OS in gastro‐esophageal cancer patients after neoadjuvant therapy . However, few studies included only stomach tumors.…”

“…There are many tumor regression grading (TRG) systems to categorize the amount of regressive changes after treatment; most of them evaluate the amount of therapy‐induced fibrosis in relation to residual tumor only at the primary lesion . Patients with complete response (pCR) or near complete regression of the tumor show significant survival benefit and reduced risk of recurrence …”

Prognostic pathological factors in radical cystectomy after neoadjuvant chemotherapy

“…TRG was assessed on the basis of the size of residual cancer tissue in relation to the size of the original tumour bed, and was found to be the only independent prognosticator for overall survival. A similar approach in assessing response to NAC has been previously used in rectal and oesophageal cancers, in which TRG has been shown to be of prognostic value; this approach has also been tested in breast and ovarian carcinomas, but with variable success . It is of note that different morphological predictors of outcome post‐NAC have been reported, such as the percentage of necrosis in high‐grade sarcomas and the size of residual tumour in ovarian serous adenocarcinoma .…”