TY - JOUR
T1 - Prognostic Value of Mandard’s Tumor Regression Grade (TRG) in Post Chemo-Radiotherapy Cervical Cancer
AU - Scaglione, G.
AU - Arciuolo, D.
AU - Travaglino, A.
AU - Santoro, Angela
AU - Angelico, G.
AU - Spadola, S.
AU - Inzani, F.
AU - D'Alessandris, Nicoletta
AU - Raffone, A.
AU - Fulgione, C.
AU - Padial, Urtueta B.
AU - Sfregola, S.
AU - Valente, M.
AU - Addante, F.
AU - d'Amati, A.
AU - Cianfrini, F.
AU - Piermattei, A.
AU - Pedone, Anchora L.
AU - Scambia, G.
AU - Ferrandina, Maria Gabriella
AU - Zannoni, Gian Franco
PY - 2023
Y1 - 2023
N2 - In locally advanced cervical cancer (LACC), definitive chemo-radiotherapy is the standard treatment, but chemo-radiotherapy followed by surgery could be an alternative choice in selected patients. We enrolled 244 patients affected by LACC and treated with CT-RT followed by surgery in order to assess the prognostic role of the histological response using the Mandard scoring system. Results: A complete pathological response (TRG 0) was observed in 118 patients (48.4%), rare residual cancer cells (TRG2) were found in 49 cases (20.1%), increased number of cancer cells but fibrosis still predominating (TRG3) in 35 cases (14.3%), and 42 (17.2%) were classified as non-responders (TRG4–5). TRG was significantly associated with both OS (p < 0.001) and PFS (p < 0.001). The survival curves highlighted two main prognostic groups: TRG1-TRG2 and TRG3-TRG4–5. Main responders (TRG1–2) showed a 92% 5-year overall survival (5y-OS) and a 75% 5-year disease free survival (5y-DFS). Minor or no responders showed a 48% 5y-OS and a 39% 5y-DFS. The two-tiered TRG was independently associated with both DFS and OS in Cox regression analysis. Conclusion. We showed that Mandard TRG is an independent prognostic factor in post-CT/RT LACC, with potential benefits in defining post-treatment adjuvant therapy.
AB - In locally advanced cervical cancer (LACC), definitive chemo-radiotherapy is the standard treatment, but chemo-radiotherapy followed by surgery could be an alternative choice in selected patients. We enrolled 244 patients affected by LACC and treated with CT-RT followed by surgery in order to assess the prognostic role of the histological response using the Mandard scoring system. Results: A complete pathological response (TRG 0) was observed in 118 patients (48.4%), rare residual cancer cells (TRG2) were found in 49 cases (20.1%), increased number of cancer cells but fibrosis still predominating (TRG3) in 35 cases (14.3%), and 42 (17.2%) were classified as non-responders (TRG4–5). TRG was significantly associated with both OS (p < 0.001) and PFS (p < 0.001). The survival curves highlighted two main prognostic groups: TRG1-TRG2 and TRG3-TRG4–5. Main responders (TRG1–2) showed a 92% 5-year overall survival (5y-OS) and a 75% 5-year disease free survival (5y-DFS). Minor or no responders showed a 48% 5y-OS and a 39% 5y-DFS. The two-tiered TRG was independently associated with both DFS and OS in Cox regression analysis. Conclusion. We showed that Mandard TRG is an independent prognostic factor in post-CT/RT LACC, with potential benefits in defining post-treatment adjuvant therapy.
KW - Mandard scoring system
KW - locally advanced cervical cancer
KW - prognostic stratification
KW - Mandard scoring system
KW - locally advanced cervical cancer
KW - prognostic stratification
UR - https://publicatt.unicatt.it/handle/10807/283486
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85175492439&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85175492439&origin=inward
U2 - 10.3390/diagnostics13203228
DO - 10.3390/diagnostics13203228
M3 - Article
SN - 2075-4418
VL - 13
SP - 1
EP - 13
JO - Diagnostics
JF - Diagnostics
IS - 20
ER -
