作者: Eva Karamitopoulou , Svenja Thies , Inti Zlobec , Katja Ott , Marcus Feith
DOI: 10.1097/PAS.0000000000000255
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摘要: Histopathologic determination of tumor regression provides important prognostic information for locally advanced gastroesophageal carcinomas after neoadjuvant treatment. Regression grading systems mostly refer to the amount therapy-induced fibrosis in relation residual or estimated percentage former site. Although these methods are generally accepted, currently there is no common standard reporting cancers. We compared application 2 major principles assessment regression: hematoxylin and eosin-stained slides from 89 resection specimens esophageal adenocarcinomas following chemotherapy were independently reviewed by 3 pathologists different institutions. Tumor was determined 5-tiered Mandard system (fibrosis/tumor relation) 4-tiered Becker (residual %). Interobserver agreement showed better weighted κ values with (0.78 vs. 0.62). Evaluation whole embedded site improved results (Becker: 0.83; Mandard: 0.73) as only 1 representative slide 0.68; 0.71). Modification into simplified 3-tiered comparable interobserver but stratification both (log rank Becker: P=0.015; P=0.03), independent impact overall survival (modified P=0.011, hazard ratio=3.07; modified P=0.023, ratio=2.72). In conclusion, provide substantial excellent estimation adenocarcinomas. A simple % (complete regression/1% 50% tumor/>50% tumor) maintains highest reproducibility value.