Prognosis of a Heterogeneous TRG Pathological Response to Neoadjuvant Chemotherapy in Patients who Undergo Resection for Colorectal Liver Metastases
- 28.03.2024
- Hepatobiliary Tumors
Erschienen in:
- Verfasst von
- Sophie Laroche, MD
- Olivier Scatton, MD, PhD
- Frederic Charlotte, MD
- Jean-Baptiste Bachet, MD, PhD
- Chetana Lim, MD, PhD
- David Fuks, MD, PhD
- Claire Goumard, MD, PhD
- Erschienen in
- Annals of Surgical Oncology | Ausgabe 7/2024
Abstract
Background
Optimal management of colorectal liver metastasis (CRLM) is based on a combination of chemotherapy and surgical resection. The tumor regression grade (TRG) score is a histological scoring system to evaluate response to chemotherapy. The prognosis of a heterogeneous response in cases of multiple metastases has not been evaluated according to the TRG score.
Patients and Methods
All patients who underwent liver resection for multiple CRLM after neoadjuvant chemotherapy in two tertiary centers from January 2015 to April 2019 were retrospectively included. Oncological characteristics and outcome between TRG 1–2–3 (good response group), TRG 4–5 (poor response group) and heterogeneous TRG (good and poor TRG among different lesions within the same patient) groups were compared.
Results
Among the 327 patients included, 134 (41.0%) had good response (TRG 1–2–3), 120 (36.7%) had poor response (TRG 4–5), and 73 (22.3%) had heterogeneous response. The type and number of cycles of chemotherapy, k-Ras mutational status, and tumor number or size did not differ between the three groups. Use of irinotecan-based and anti-VEGF neoadjuvant therapy was associated with better TRG response [irinotecan-based: hazard ratio (OR) = 1.744; p = 0.045; anti-VEGF neoadjuvant therapy: 2.054; p = 0.005). Overall survival (OS) was higher in the 1–2–3 TRG group than in the heterogeneous TRG group (2-year OS = 81.3% vs. 60.3%, respectively; p = 0.003) and the 4–5 TRG group (2-year OS = 81.3% vs. 55.0%, respectively; p = 0.012) and similar between the heterogeneous and 4–5 TRG groups.
Conclusions
The proportion of heterogeneous pathological response according to TRG is 22.3%, and the prognosis is comparable to that of poor pathological response.
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- Titel
- Prognosis of a Heterogeneous TRG Pathological Response to Neoadjuvant Chemotherapy in Patients who Undergo Resection for Colorectal Liver Metastases
- Verfasst von
-
Sophie Laroche, MD
Olivier Scatton, MD, PhD
Frederic Charlotte, MD
Jean-Baptiste Bachet, MD, PhD
Chetana Lim, MD, PhD
David Fuks, MD, PhD
Claire Goumard, MD, PhD
- Publikationsdatum
- 28.03.2024
- Verlag
- Springer International Publishing
- Erschienen in
-
Annals of Surgical Oncology / Ausgabe 7/2024
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681 - DOI
- https://doi.org/10.1245/s10434-024-15196-x
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