Table 1. TRG classification systems

TRG TRG 0 TRG 1 TRG 2 TRG 3 TRG 4 TRG 5
Mandard CR, no viable cancer cells, fibrosis extending through the different layers of the wall Rare residual cancer cells scattered through the fibrosis Increased number of residual cancer cells, fibrosis predominates Residual cancer outgrowing fibrosis Absence of regressive changes
Dworak No response Minimal response (dominant tumor mass with obvious fibrosis, vasculopathy); fibrosis <25% of tumor mass Moderate response (dominant fibrotic changes with a few easy-to-find tumor cells in groups); fibrosis 25%–50% of tumor mass Near CR (few microscopically difficult-to-find tumor cells in fibrotic tissue with or without mucous substance); fibrosis >50% of tumor mass CR (no tumor cells, only fibrotic mass or acellular mucin pools)
Ryan/AJCC CR, no viable cancer cells Near-CR, single cells, or rare small groups of cancer cells Partial response, residual cancer with evident tumor regression but more than single cells or rare small group of cancer cells Poor or no response, extensive residual cancer with no evident tumor regression
MSKCC 100% tumor response 86%–99% tumor response ≤85% tumor response
TRG, tumor regression grade; CR, complete response; AJCC, American Joint Committee on Cancer; MSKCC, Memorial Sloan-Kettering Cancer Center.