Mandard et al described different histologic grades of tumor regression following preoperative chemoradiotherapy in patients with esophageal carcinoma. The authors are from Caen and Vannes, France.
Sites evaluated:
(1) primary tumor
(2) lymph node metastases
|
Primary Tumor |
Fibrosis |
Assessment |
Grade |
|
no residual cancer |
diffuse |
complete regression |
1 |
|
rare residual cancer cells |
diffuse |
|
2 |
|
some residual tumor |
predominant |
|
3 |
|
predominant |
some fibrosis |
|
4 |
|
no sign of therapy effect |
none or minimal |
no regression |
5 |
where:
• Granulomas may or may not be present in Grades 1 and 2.
|
Lymph Nodes |
Fibrosis |
Assessment |
Grade |
|
no viable cancer (keratin plugs or squamous ghost cells) |
dense and diffuse |
complete regression |
1 |
|
rare residual cancer cells |
diffuse |
|
2 |
|
some residual tumor |
predominant |
|
3 |
|
predominant |
some fibrosis |
|
4 |
|
no sign of therapy effect |
none or minimal |
no regression |
5 |
The presence of tumor regression (grades 1-3) is a significant predictor of disease free survival.
|
Tumor Regression Grade |
Percent Disease Free Survival at 2 Years |
|
1 or 2 |
62% |
|
3 |
25% |
|
4 |
10% |
|
5 |
0% |
from Figure 6, page 2685.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
