Tumor deposit is an independent prognostic indicator in patients who underwent radical resection for colorectal cancer

Abstract

Background: Tumor deposits are one of the promising factors among the different edition of Tumor, Node, Metastasis classification. Despite improvement in the treatment of various types of metastatic disease the source and prognostic significance of tumor deposits in staging has not been deliberating the agreeable opinion. We investigated the possibility of tumor deposit as independent prognostic factor and evaluating its prognostic value in colorectal carcinoma patients.Methods: Author studied 313 colorectal cancer patients clinocopathological data and outcome who underwent radical resection. Data between 2011-2015 were retrospectively collected from Shanghai East Hospital, affiliated with Tongji University data information centre. The analysis was used to calculate 2 years disease free survival(DFS) and relation of tumor deposit with number of lymph node positive. Cox-regression analysis was performed to assess the prognostic factor.Results: Out of 313 colorectal patients included in the study, tumor deposits were detected in 17%. Tumor deposits (TDs) are relevantly associated with significant poor outcomes. The tumor deposit were significantly correlated with T-stage(P=<0.001), N-stage(P=<0.001), PLNC(P=<0.001), venous invasion(P=<0.001), TNM staging(P=<0.001), CEA(P=0.021) and CA19-9(P=0.042) of primary tumor. The Kaplan-Meier analysis revealed that disease-free survival of CRC patients with positive tumor deposit were significantly poorer that those with negative tumor deposit cohort(P=<0.001) And with multivariate analysis in different model, we found that positive tumor deposit were significantly associated with shorter DSF which is totally independent with lymph node status (P=0.001 and P=0.023 respectively). Subgroup analysis found that of 179 CRC patients with negative lymph node status, the DFS of patients with positive tumor deposit were significantly shorter that those with negative tumor deposit(P=,0.001). Of 134patients with positive lymph node status, the DFS of patients shows similar result. (P=<0.001).Conclusion: We have shown that TDs are not equal to lymph node metastasis with respect to biology and outcome. Tumor deposits are an independent adverse prognostic factor in CRC patient who have undergone radical resection.

The Prognostic Significance of Tumor Deposit Count for Colorectal Cancer Patients after Radical Surgery

“…Mayo et al [16] showed that TDs were associated with worse 3-year OS overall survival in patients of any known and unknown N categories, which suggested that TDs might be associated with a risk of all-cause death or cancer-specific death at least similar to a positive lymph node in all N categories. Basnet et al [17] signified that TD was an independent prognostic factor associated with metastatic diseases along with vascular invasion and the number of metastatic lymph nodes among CRC patients. All these studies indicated that it might be more reasonable to differentiate prognostic significance of TD status from that of metastatic lymph nodes [18], and more details of TDs should be explored in CRC patients.…”

A Modified Pathological N Stage Including Status of Tumor Deposits in Colorectal Cancer With Nodal Metastasis

“…However, it remains unclear how to classify TDs in the TNM classification. Some researchers have suggested that TDs should be counted as positive LNs, and that this may be superior to the (25). These findings suggest that TDs may differ from positive LNs and may have specific prognostic characteristics.…”

“…Furthermore, Basnet et al. demonstrated that TDs were not equivalent to positive LNs, but did not provide detailed information about the exact role of TDs ( 25 ). These findings suggest that TDs may differ from positive LNs and may have specific prognostic characteristics.…”

<p>Impact of Nutritional Indices on the Survival Outcomes of Patients with Colorectal Cancer</p>

“…2 Colorectal cancer is the third leading cause of morbidity and mortality in both men and women. 3 With the improvement in living standards and changes in diet, the incidence of colorectal cancer continues to rise. 4 The treatment of colorectal cancer includes surgery, chemotherapy, radiotherapy and other biological immunological treatments.…”