Prognostic Significance of Tumor Deposits in Stage III Colon Cancer

Mirkin, Katelin A.; Kulaylat, Audrey S.; Hollenbeak, Christopher S.; Messaris, Evangelos

doi:10.1245/s10434-018-6661-9

Cited by 49 publications

(50 citation statements)

References 16 publications

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“…It was reported that patients with tumor deposits alone, as compared with those with lymph node metastasis alone, were less likely to undergo lymph node dissection and adjuvant chemotherapy. 13 Our findings suggest that tumor deposits are also critical prognostic risk factors and require active treatment. Moreover, subsequent studies are required to determine whether the size, contour, and number of tumor deposits impact prognosis and how tumor deposition exerts biological effects.…”

Section: Discussionmentioning

confidence: 72%

“…The prognostic implications of tumor deposits alone were similar to those of LNMs alone, whereas tumor deposits concomitant with LNMs exhibited significantly worse prognosis, which are consistent with previous studies. 13,17 Nagtegaal et al reported that tumor deposits occur more frequently in cases with extramural vascular invasion and other types of regional spread, and the presence of tumor deposits and LNMs significantly increased the risk of liver metastasis, as compared with those with LNM alone. 18 Multiple metastatic pathways in tumors will result in a wider spread of tumors.…”

Section: Discussionmentioning

confidence: 99%

“…11 Evidence from some studies suggests that patients with both tumor deposits and lymph node metastases (LNMs) have a worse prognosis than patients with either alone. 12,13 Although tumor deposits in colon cancer are a major issue, relatively few predictive models have considered them. In addition, although a nomogram based on clinical risk factors to predict individualized prognosis is more accurate than the AJCC staging system, 14 there has been no report of a prognostic nomogram that incorporates tumor deposits in colon cancer.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic Significance of Tumor Deposits in Patients With Stage III Colon Cancer: A Nomogram Study

Zheng

Chen

et al. 2020

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Significance of Tumor Deposits in Patients With Stage III Colon Cancer: A Nomogram Study

Zheng

Chen

et al. 2020

Journal of Surgical Research

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“…Tumor deposits had been considered as an indicator of poor prognosis in colorectal cancer ( 9 – 11 ). What is more, it was reported that patients with both TDs and lymph node metastasis would have a worse prognosis than patients with either alone ( 12 , 13 ). However, no previous studies had evaluated the role of TDs in predicting the efficacy of chemotherapy in stage III colon cancer.…”

Section: Introductionmentioning

confidence: 95%

The Role of Tumor Deposits in Predicting the Efficacy of Chemotherapy in Stage III Colon Cancer

Shi¹,

Zhang²,

Yao³

et al. 2020

Front. Oncol.

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Purpose To evaluate the role of tumor deposits (TDs) in predicting the efficacy of chemotherapy in stage III colon cancer. Methods Using the SEER ∗ Stat software Version 8.3.6, we started with a national cohort of colon cancer cases diagnosed between 2004 and 2016. We used the χ 2 (Chi-square) test to compare differences between different categorical variables according to the number of TDs. The Cox proportional hazards regression model was used to determine the independent association of different clinical and pathological variables with CSS, which were adjusted for other significant prognostic factors. Results We have identified 29,017 patients diagnosed with stage III colon cancer from the SEER database. The results of multivariate analyses showed that patients with the receipt of chemotherapy had 54.7% decreased risk of cancer-specific mortality compared with those not (HR = 0.453, 95% CI = 0.425–0.483, P < 0.0001) in the no-TD group; In the 1–2-TD group, patients with the receipt of chemotherapy had 56.8% decreased risk of cancer-specific mortality compared with those not (HR = 0.432, 95% CI = 0.364–0.512, P < 0.0001); In the ≥3-TD group, patients with the receipt of chemotherapy had 51.8% decreased risk of cancer-specific mortality compared with those not (HR = 0.482, 95% CI = 0.389–0.597, P < 0.0001). Conclusions Our study demonstrated that the presence of TDs was associated with a dismal prognosis and high number of TDs would also contribute to the worse survival of colon cancer. High number of TDs did not affect the survival benefit of chemotherapy in stage III colon cancer.

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“…Recent adjusted analyses of a larger sample, the National Cancer Database, found that tumor deposits were associated with worse survival in stage III patients, and further stratifies outcomes for LN-positive and LN-negative patients. 4,5 Osterman et al 6 found that right-sided tumors, a variable of interest in patients with metastatic disease, was associated with recurrence, but their recent analysis using the larger national Swedish Colorectal Cancer registry did not find this to be a strong predictor of prognosis in curatively respected patients. Sidedness warrants further investigation; its predictive value may be confounded by more specific factors that were not available in this and other analyses, such as BRAF mutation or microsatellite instability.…”

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confidence: 99%

Postoperative CEA and Other Non-traditional Risk Factors for Colon Cancer Recurrence: Findings from Swedish Population-Based Data

Kwaan

2019

Ann Surg Oncol

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Adjuvant chemotherapy after curative resection of colon cancer is a critical intervention in our efforts to decrease cancer-specific mortality. Selection of the correct population for treatment is the subject of ongoing investigation and is particularly controversial in high-risk stage II patients. In this issue of Annals of Surgical Oncology, Osterman et al. 1 use population-based data from Uppsala County in Sweden to investigate 'emerging' risk factors for colon cancer recurrence and mortality. 'Emerging' predictor variables [sidedness, pT3 and pT4 subclassification, lymph node (LN) ratio, tumor deposits, pre-and postoperative carcinoembryonic antigen (CEA) and C-reactive protein (CRP) levels] were distinguished from 'classic' risk factors (emergency surgery, pT and pN classification, low LN yield, malignancy grade, vascular and perineural invasion, and adjuvant treatment). Underpinning their study is the use of population-based data with granular detail, few missing data, and long duration (median 5.5 years) follow-up. Their cohort included 416 patients treated in Uppsala County in the modern era. In an adjusted analysis, after controlling for 'classic' risk factors, postoperative CEA [ 5 ng/mL, right-sided tumors, and nodal subclassification stages (pN1a, pN1b, etc.) were associated with recurrence. Perhaps the most valuable finding from this study is that it confirms postoperative CEA, rather than preoperative CEA, as a predictor of cancer recurrence. In a study of

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Prognostic Significance of Tumor Deposits in Stage III Colon Cancer

Abstract: Concomitant presence of tumor deposits and lymph node invasion carries poor prognostic significance. Tumor deposits alone appear to have prognostic implications similar to lymph node invasion alone.

Cited by 49 publications

References 16 publications

Prognostic Significance of Tumor Deposits in Patients With Stage III Colon Cancer: A Nomogram Study

Prognostic Significance of Tumor Deposits in Patients With Stage III Colon Cancer: A Nomogram Study

The Role of Tumor Deposits in Predicting the Efficacy of Chemotherapy in Stage III Colon Cancer

Postoperative CEA and Other Non-traditional Risk Factors for Colon Cancer Recurrence: Findings from Swedish Population-Based Data

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