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Prognostic Significance of Tumor Deposits in Stage III Colon Cancer

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The American Joint Committee on Cancer includes extranodal tumor deposits in the tumor–node–metastasis classification of colon cancer. However, it is unclear how tumor deposits compare with lymph node metastases in prognostic significance. This study evaluated the survival impact of tumor deposits relative to lymph node metastases in stage III colon cancer.

Methods

The US National Cancer Database (2010–2012) was reviewed for resectable stage III adenocarcinoma of the colon, and stratified by presence of tumor deposits and lymph node metastases. Univariate and multivariate survival analyses were performed.

Results

Of 6424, 10.1% had both tumor deposits and lymph node metastases [5-year survival (5YS) 40.2%], 2.5% had tumor deposits alone (5YS 68.1%), and 87.4% had lymph node metastases alone (5YS 55.4%). Patients with lymph node metastases alone tended to have a greater number of lymph nodes retrieved (20.9 versus 18.8, p = 0.0126) and were more likely to receive adjuvant therapy (66.9 vs 58.0%, p = 0.003) than those with only tumor deposits. Patients with both had significantly worse survival at all T stages (p < 0.05, all). There was no significant difference in survival between tumor deposits alone and lymph node metastases alone at any T stage (p > 0.8, all). After controlling for patient, disease, and treatment characteristics, patients with tumor deposits alone [hazard ratio (HR) 0.56, p = 0.001] or only lymph node metastases (HR 0.64, p < 0.001) were associated with improved survival relative to patients with both.

Conclusions

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.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA

    Katelin A. Mirkin MD, Audrey S. Kulaylat MD, Christopher S. Hollenbeak PhD & Evangelos Messaris MD, PhD

  2. Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA

    Christopher S. Hollenbeak PhD

Authors
  1. Katelin A. Mirkin MD
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  2. Audrey S. Kulaylat MD
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  3. Christopher S. Hollenbeak PhD
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  4. Evangelos Messaris MD, PhD
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Corresponding author

Correspondence to Evangelos Messaris MD, PhD.

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All authors declare that they have no conflict of interest.

Disclaimer

The National Cancer Data Base (NCDB) is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The CoC’s NCDB and the hospitals participating in the CoC NCDB are the source of the de-identified data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

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Mirkin, K.A., Kulaylat, A.S., Hollenbeak, C.S. et al. Prognostic Significance of Tumor Deposits in Stage III Colon Cancer. Ann Surg Oncol 25, 3179–3184 (2018). https://doi.org/10.1245/s10434-018-6661-9

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  • DOI: https://doi.org/10.1245/s10434-018-6661-9

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