Preoperative chemoradiation is performed to reduce tumor burden prior to surgery. Dworak et al reported a scheme. The authors are from Chirurgischen Klinik and Strahlentherapeutische Klinik in Erlangen, Germany.
Patient selection: rectal cancer status post preoperative chemoradiation
Parameters:
(1) percent tumor regression
(2) fibrosis
Tumor Regression
Fibrosis
Tumor Regression Grade
none to minimal
NA
TRG 0
mostly tumor
some fibrosis with or without vasculopathy
TRG 1
few tumor cells or groups but easy to find
predominant
TRG 2
very few tumor cells that are difficult to find
extensive
TRG 3
no tumor cells despite search
fibrotic mass
TRG 4 (total regression)
Interpretation:
• Total tumor regression is associated with a better prognosis.
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