Significance of Tumor Deposits combined with Lymph Node Metastasis in Stage III Colorectal Cancer Patients: A retrospective multi-center cohort study from China

Abstract

Purpose The study aimed to explore the value of tumor deposits in stage III colorectal cancer (CRC) and verify whether patients with more tumor deposit numbers have higher risk of recurrence. Methods The retrospective cohort analysis was performed at two cancer centers of China. Stage III CRC patients who underwent radical resection at the center between April 2008 and February 2019 were identified. The Univariate/Multivariate Cox regression, Kaplan-Meier analysis, and PSM were recurrence-free survival (RFS) used. Results Total 1080 stage III CRC patients (634 [58.7%] men; median [IQR] age, 60 [50–68] years) underwent radical surgical resection were identified for inclusion in this study. Patients with tumor deposits had a 12.8% lower 3-year RFS (n = 236 [69.9%]) than the patients without tumor deposits (n = 844 [82.7%]) (P ≤ 0.0001). The 3-year RFS of patients with stage N2 (n = 335 [61.2%]) was 18.6% lower (P ≤ 0.0001) than the original cohort of patients with stage N1 (n = 745 [79.8%]), but it was similar to the RFS of patients with 4 or more tumors deposits plus lymph node metastases (n = 58 [61.4%]) (P = 0.91). The RFS for patients with 4 or more tumor deposits plus number of lymph node metastases (n = 58 [61.4%]) was 15.8% lower than the cohort of patients with 1–3 tumor deposits + number of lymph node metastases (n = 687 [77.2%]) % (P = 0.001). Multivariate analysis confirmed that patients with 4 or more tumor deposits + the number of lymph node metastases (hazard ratio [HR], 1.88; 95% CI, 1.24–2.87) was independently associated with a shorter RFS. Conclusion The number of tumor deposits is an indicator of poor postoperative prognosis. It is necessary to incorporate the number of tumor deposits combined with the number of lymph node metastases to stratify postoperative stratification of stage III CRC, which may provide a new theoretical basis for adjuvant therapy for patients with N1 stage CRC after surgery.

Effects of magnetic resonance imaging (MRI)-detected extramural vascular invasion (mrEMVI) and tumor deposits (TDs) on distant metastasis and long-term survival after surgery for stage III rectal cancer: a retrospective study grouped based on the relationship between the bottom of the tumor and peritoneal reflection

“…In recent years, the lymph node ratio (LNR) has attracted increasing attention as a strong predictor of long-term survival in CRC patients after radical resection (16)(17)(18), and many researchers have also proposed calculating TDs as positive lymph nodes (19), so as to further explore the impact of the new LNR on the long-term survival of rectal cancer patients after radical resection. Pu et al proposed that the new LNR was better than others in predicting long-term outcomes, and calculated the optimal intercept value of this new LNR (20). Another retrospective study based on the Chinese population showed that it was necessary to combine the number of TDs with the number of positive lymph nodes.…”