医学
一致性
病态的
化疗
模式治疗法
肿瘤科
放射科
放射治疗
阶段(地层学)
内科学
生物
古生物学
作者
Giuseppe Nicolò Fanelli,Fotios Loupakis,Elizabeth C Smyth,Marco Scarpa,Sara Lonardi,Salvatore Pucciarelli,Giada Munari,Massimo Rugge,Nicola Valeri,Matteo Fassan
标识
DOI:10.1177/1066896919869477
摘要
Preoperative chemotherapy or combined radiotherapy and chemotherapy (CRT), followed by surgery, represents the standard approach for locally advanced esophageal, gastric, and rectal carcinomas. To adequately evaluate the effects of neoadjuvant CRT in the resection specimens, several histopathologic tumor regression grade (TRG) scoring systems have been introduced into clinical practice. The primary goal of these TRG systems relies on a correct prognostic stratification of patients in the attempt to help clinical decision-making and influence surgical strategies, postoperative adjuvant therapies, and surveillance intensity. However, most TRG systems suffer from poor reproducibility and low interobserver concordance rates. Many efforts have been made in the identification of alternative, robust, simple, and universally accepted TRG scoring systems, which would help in the comparison of different treatment strategies and in the standardization of multimodal therapies. The aim of this review is to analyze the most commonly used TRG systems in gastrointestinal cancers highlighting their pitfalls and usefulness, depending on the tumor type.
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