Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2021; 13(12): 2161-2179
Published online Dec 15, 2021. doi: 10.4251/wjgo.v13.i12.2161
Comparison of tumor regression grading systems for locally advanced gastric adenocarcinoma after neoadjuvant chemotherapy
Zi-Ning Liu, Yin-Kui Wang, Li Zhang, Yong-Ning Jia, Shan Fei, Xiang-Ji Ying, Yan Zhang, Shuang-Xi Li, Yu Sun, Zi-Yu Li, Jia-Fu Ji
Zi-Ning Liu, Yin-Kui Wang, Yong-Ning Jia, Shan Fei, Xiang-Ji Ying, Yan Zhang, Shuang-Xi Li, Zi-Yu Li, Jia-Fu Ji, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
Li Zhang, Yu Sun, Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Liu ZN, Wang YK and Li ZY designed this study; Wang YK and Liu ZN enrolled patients and collected clinical data; Zhang L and Sun Y reviewed the samples; Liu ZN and Ying XJ conducted statistical analysis; Liu ZN is responsible for data visualization; Liu ZN and Wang YK drafted this article; All authors read and approved the final manuscript; Liu ZN, Wang YK and Zhang L contributed equally to this work.
Supported by the Beijing Municipal Health Commission, No. DFL20181103 and No. ZYLX201701.
Institutional review board statement: The Ethics Committee of Peking University Cancer Hospital approved this study. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consents were obtained from all patients for being included in the study. This study does not involve animal study.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi-Yu Li, MD, PhD, Professor, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. ziyu_li@hsc.pku.edu.cn
Received: May 12, 2021
Peer-review started: May 12, 2021
First decision: July 14, 2021
Revised: July 25, 2021
Accepted: September 15, 2021
Article in press: September 15, 2021
Published online: December 15, 2021
ARTICLE HIGHLIGHTS
Research background

The tumor regression grade systems for gastric cancer (GC) are various, while the most suitable one is yet to be known.

Research motivation

We aimed to investigate the most accurate criteria for TRG in predicting patient’s prognosis.

Research objectives

To collect 413 locally advanced GC (LAGC) patient’s clinical data and their post-treatment pathological samples after neoadjuvant chemotherapy treatment.

Research methods

This is a retrospectively clinical study in which the LAGC patient’s specimens were reviewed by two pathologists and the TRG grades were revalued. Then, the predictive abilities of five TRG criteria were assessed and statistically compared based on survival/risk prediction model.

Research results

The four-tier Becker system showed the highest predictive ability, among the five common TRG criteria. The TRG criteria could achieve an optimal prediction when the residual tumor percentages were reset as: “no residual tumor”, < 10%, < 100%, and “no response”.

Research conclusions

The four-tier Becker system is more suitable and should be recommended for LAGC patients.

Research perspectives

A population-based study is warranted to define the optimal criterion for TRG for GC.