J Cancer 2018; 9(21):3979-3985. doi:10.7150/jca.27475
Tumor deposit is an independent prognostic indicator in patients who underwent radical resection for colorectal cancer
1. Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
2. Research Centre for Translational Medicine, Key Laboratory of Arrhythmias, Ministry of Education, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
3. Dulegaunda Polyclinic and Research Centre, Gandaki Province, Nepal
4. B.P Koirala Memorial Cancer Hospital Bharatpur Nepal
5. Metro city Hospital and Research Centre Gandaki Province Nepal
6. University of Maryland College Park, School of Public Health, USA
7. Department of Internal Medicine, Gautam Buddha Community Heart Hospital Butwal Nepal.
8. National Center for Rheumatic Diseases, Ratopul Kathmandu Nepal.
9. Max Hospital, Emergency Department, New Delhi Gurgaon India
Basnet S, Lou Qf, Liu N, Rana R, Shah A, Khadka M, Warrier H, Sigdel S, Dhakal S, Devkota A, Mishra R, Sapkota G, Zheng L, Ge Hy. Tumor deposit is an independent prognostic indicator in patients who underwent radical resection for colorectal cancer. J Cancer 2018; 9(21):3979-3985. doi:10.7150/jca.27475. Available from http://www.jcancer.org/v09p3979.htm
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.
Keywords: Colorectal cancer, Tumor deposit, Prognosis, Survival, lymph nodes.