2016
DOI: 10.1097/pas.0000000000000738
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Validation of a Proposed Tumor Regression Grading Scheme for Pancreatic Ductal Adenocarcinoma After Neoadjuvant Therapy as a Prognostic Indicator for Survival

Abstract: Neoadjuvant therapy has been increasingly used to treat patients with potentially resectable pancreatic ductal adenocarcinoma (PDAC). Although the College of American Pathologists (CAP) grading scheme for tumor response in post-therapy specimens has been used, its clinical significance has not been validated. Previously, we proposed a three-tier histologic tumor regression grading (HTRG) scheme (HTRG 0, no viable tumor; HTRG 1, < 5% viable tumor cells; HTRG 2, ≥5 % viable tumor cells) and showed that the three… Show more

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Cited by 99 publications
(90 citation statements)
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References 27 publications
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“…There were no R2 resections. According to our proposed modified CAP grading scheme for residual carcinoma (4, 5), 9 cases (2.3%) had modified CAP grade 0 response; 54 cases (13.6%) had modified CAP grade 1 response, and 335 cases (84.2%) modified CAP grade 2 response. The total number of lymph nodes examined ranged from 12 to 68, with a median of 22.…”
Section: Resultsmentioning
confidence: 99%
“…There were no R2 resections. According to our proposed modified CAP grading scheme for residual carcinoma (4, 5), 9 cases (2.3%) had modified CAP grade 0 response; 54 cases (13.6%) had modified CAP grade 1 response, and 335 cases (84.2%) modified CAP grade 2 response. The total number of lymph nodes examined ranged from 12 to 68, with a median of 22.…”
Section: Resultsmentioning
confidence: 99%
“…Subsequently, they showed in 2 separate multivariable analysis models that the pathologic response in group 1 was an independent prognostic factor for OS in both models, but not DFS. Also from MD Anderson, Lee et al 24 reported 3 patients (2%) with a pCR and 18 patients (11%) with <5% residual carcinoma in the surgical specimen after neoadjuvant therapy. Conversely from the results presented by Chatterjee et al, multivariable analysis showed an independent association with improved DFS ( P = 0.03), but not OS ( P = 0.12) 9 .…”
Section: Discussionmentioning
confidence: 99%
“…The patients were divided on the basis of their response to NAC, which was determined by the residual tumor viability in the specimen. Based on the previously described classification methods (13), the tumors with ≤30% viable tumor cells (i.e., HTRG grade 0, CAP grade 0; HTRG grade 1, CAP grade 1; and HTRG grade 2, CAP grade 2: complete to moderate response) were graded "good-responders, " while tumors with >30% viable tumor cells (HTRG grade 2, CAP grade 3; poor response) were graded as "poor-responders." The good-responders had significantly (p < 0.05) longer overall survival compared to poor-responders ( Figure 1B).…”
Section: Population Demographics and Survival Datamentioning
confidence: 99%