Tsagkalidis, V.; Blaszczyk, M.B.; In, H. Interpretation of Tumor Response Grade following Preoperative Therapy for Gastric Cancer: An Overview. Cancers2023, 15, 3662.
Tsagkalidis, V.; Blaszczyk, M.B.; In, H. Interpretation of Tumor Response Grade following Preoperative Therapy for Gastric Cancer: An Overview. Cancers 2023, 15, 3662.
Tsagkalidis, V.; Blaszczyk, M.B.; In, H. Interpretation of Tumor Response Grade following Preoperative Therapy for Gastric Cancer: An Overview. Cancers2023, 15, 3662.
Tsagkalidis, V.; Blaszczyk, M.B.; In, H. Interpretation of Tumor Response Grade following Preoperative Therapy for Gastric Cancer: An Overview. Cancers 2023, 15, 3662.
Abstract
Gastric cancer is among the top 5 causes of cancer-related death worldwide. Preoperative chemotherapy has been established as an option in patients with locally advanced gastric cancer. However, chemotherapy yields variable results, owing to the cellular and molecular heterogeneity of this disease. Identifying patients who did or did not respond to preoperative therapy can allow clinicians to alter treatment modalities and provide important information related to prognostication. Pathologic response to preoperative therapies, called Tumor Response Grade (TRG), has been evaluated to quantify treatment response. Multiple systems for TRG have been established. However, literature has demonstrated inconsistent results for TGR systems and prognosis, possibly due to variability in interpretation of tumor response between systems and interobserver variability. Radiographic response to preoperative therapies using RECIST 1.1 criteria and endoscopically-assessed tumor response have demonstrated association with survival; however their use in gastric cancer remains challenging given the inability to accurately and consistently identify and measure the tumor, especially in the setting of neoadjuvant therapy where treatment-related changes can obscure the gastric wall layers. This review is focused on summarizing the available literature related to evaluating TRG in gastric cancer, as well as providing a brief overview on the use of radiographic and endoscopic methods to assess response to preoperative therapies. Lastly, we outline future directions regarding the use of a universal TRG system to guide care and assist with prognosis.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
