Prognostic value of pathological lymph node status and primary tumour regression grading following neoadjuvant chemotherapy - results from the MRC OE02 oesophageal cancer trial

Histopathology
Nasser DavarzaniHeike I Grabsch

Abstract

Neoadjuvant chemotherapy (NAC) remains an important therapeutic option for advanced oesophageal cancer (OC). Pathological tumour regression grade (TRG) may offer additional information by directing adjuvant treatment and/or follow-up but its clinical value remains unclear. We analysed the prognostic value of TRG and associated pathological factors in OC patients enrolled in the Medical Research Council (MRC) OE02 trial. Histopathology was reviewed in 497 resections from OE02 trial participants randomised to surgery (S group; n = 244) or NAC followed by surgery [chemotherapy plus surgery (CS) group; n = 253]. The association between TRG groups [responders (TRG1-3) versus non-responders (TRG4-5)], pathological lymph node (LN) status and overall survival (OS) was analysed. One hundred and ninety-five of 253 (77%) CS patients were classified as 'non-responders', with a significantly higher mortality risk compared to responders [hazard ratio (HR) = 1.53, 95% confidence interval (CI) = 1.05-2.24, P = 0.026]. OS was significantly better in patients without LN metastases irrespective of TRG [non-responders HR = 1.87, 95% CI = 1.33-2.63, P < 0.001 versus responders HR = 2.21, 95% CI = 1.11-4.10, P = 0.024]. In multivariate analyses, LN ...Continue Reading

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Citations

May 24, 2019·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Yohei NagaiHideo Baba
Nov 5, 2019·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·F KlevebroM Nilsson
May 14, 2020·The Journal of Pathology. Clinical Research·Daniel ReimRupert Langer
Sep 6, 2020·Esophagus : Official Journal of the Japan Esophageal Society·Willem J KoemansHeike I Grabsch
Apr 25, 2021·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Eliza HagensSheraz R Markar

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Methods Mentioned

BETA
surgical resection
dissection

Software Mentioned

Aperio ImageScope

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