Skip to main content
SpringerLink
Log in

Prognostic Value of Tumor Deposits in Stage III Colorectal Cancer Patients with Different N Stages: A Population-Based, Retrospective, Cohort Study

  • Global Health Services Research
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Tumor deposits (TDs) seem to be associated with the prognosis of patients with colorectal cancer (CRC). The goal of this study was to investigate the prognostic value of TDs among patients with stage III CRC at different N stages.

Methods

A retrospective analysis was performed on two independent cohorts of stage III CRC patients from the Surveillance, Epidemiology, and End Results (SEER) database (n = 8232) and the First Affiliated Hospital of Wenzhou Medical University (n = 423). Primary outcomes were overall survival (OS) and cancer-specific survival (CSS).

Results

Of 8232 patients in the SEER cohort, the presence of TDs revealed poorer 5-year OS rates and 5-year CSS rates in all N-stage subgroups. X-tile software identified 5 (5-year OS: P = 0.004; 5-year CSS: P < 0.001) as the optimal cutoff value for TD count in the TD-positive subgroup at the N2 stage. The OS (5-year OS: 62.0% vs. 42.0%, P < 0.001) and CSS (5-year CSS: 66.0% vs. 43.8%, P < 0.001) of patients with five or more TDs were significantly worse than those with one to four TDs in the N2 stage subgroups. Of 423 patients in the Wenzhou cohort, the 3-year OS rate for patients in the positive group was worse than that for patients in the negative group (88.7% vs. 94.3%, P = 0.015).

Conclusions

TD count should be considered when evaluating the prognosis of patients with the N2 stage. Those with higher TD counts (≥ 5) might have a worse prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.

    Article  PubMed  Google Scholar 

  2. Sobin LH, Wittekind CH. International Union against Cancer TNM classification of malignant tumors. 5th edn. New York: Wiley; 1997.

    Google Scholar 

  3. Greene FL, Page DL, Fleming ID. AJCC cancer staging manual. 6th edn. New York: Springer-Verlag; 2002.

    Book  Google Scholar 

  4. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual. 7th edn. New York: Springer-Verlag; 2010.

    Google Scholar 

  5. Weiser MR. AJCC 8th edition: colorectal cancer. Ann Surg Oncol. 2018;25(6):1454–5. https://doi.org/10.1245/s10434-018-6462-1.

    Article  PubMed  Google Scholar 

  6. Gabriel CD, Bussey HJR. Lymphatic spread in cancer of the rectum. Br J Surg. 1935;23(90):395–413.

    Article  Google Scholar 

  7. Benson AB, Venook AP, Al-Hawary MM, et al. Colon cancer, version 2.2021, NCCN clinical practice guidelines in Oncology. J Natl Compr Cancer Network JNCCN. 2021;19(3):329–59.

    Article  PubMed  Google Scholar 

  8. Benson AB, Venook AP, Al-Hawary MM, et al. Rectal cancer, version 2.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Network JNCCN. 2022;20(10):1139–67.

    Article  CAS  PubMed  Google Scholar 

  9. Pu H, Pang X, Fu J, et al. Significance of tumor deposits combined with lymph node metastasis in stage III colorectal cancer patients: a retrospective multi-center cohort study from China. Int J Colorectal Dis. 2022;37(6):1411–20.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Long Q, Xu Y, Ma G, Mao W. Prognostic value of tumor deposit counts in patients with stage III colorectal cancer: a population-based study. J Invest Surg. 2022; 1–8.

  11. Pyo DH, Kim SH, Ha SY, et al. Revised nodal staging integrating tumor deposit counts with positive lymph nodes in patients with stage III colon cancer. Ann. Surg. 2021.

  12. Cohen R, Shi Q, Meyers J, et al. Combining tumor deposits with the number of lymph node metastases to improve the prognostic accuracy in stage III colon cancer: a post hoc analysis of the CALGB/SWOG 80702 phase III study (Alliance). Ann Oncol. 2021;32(10):1267–75.

    Article  CAS  PubMed  Google Scholar 

  13. Zheng K, Zheng N, Xin C, et al. The prognostic significance of tumor deposit count for colorectal cancer patients after radical surgery. Gastroenterol Res Pract. 2020;2020:2052561.

    PubMed  PubMed Central  Google Scholar 

  14. Wang S, Guan X, Ma M, et al. Reconsidering the prognostic significance of tumour deposit count in the TNM staging system for colorectal cancer. Sci Rep. 2020;10(1):89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Nagtegaal ID, Knijn N, Hugen N, et al. Tumor deposits in colorectal cancer: Improving the value of modern staging-a systematic review and meta-analysis. J Clin Oncol. 2017;35(10):1119–27.

    Article  PubMed  Google Scholar 

  16. Mayo E, Llanos AA, Yi X, Duan SZ, Zhang L. Prognostic value of tumour deposit and perineural invasion status in colorectal cancer patients: a SEER-based population study. Histopathology. 2016;69(2):230–8.

    Article  PubMed  Google Scholar 

  17. Jin M, Roth R, Rock JB, Washington MK, Lehman A, Frankel WL. The impact of tumor deposits on colonic adenocarcinoma AJCC TNM staging and outcome. Am J Surg Pathol. 2015;39(1):109–15.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Shi M, Zhang H, Yao G, et al. The role of tumor deposits in predicting the efficacy of chemotherapy in stage III colon cancer. Front Oncol. 2020;10:586603.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Delattre JF, Cohen R, Henriques J, et al. Prognostic value of tumor deposits for disease-free survival in patients with stage III colon cancer: a post hoc analysis of the IDEA France Phase III trial (PRODIGE-GERCOR). J Clin Oncol. 2020;38(15):1702–10.

    Article  PubMed  Google Scholar 

  20. Goldstein NS, Turner JR. Pericolonic tumor deposits in patients with T3N+ MO colon adenocarcinomas: markers of reduced disease free survival and intra-abdominal metastases and their implications for TNM classification. Cancer. 2000;88(10):2228–38.

    Article  CAS  PubMed  Google Scholar 

  21. Shimada Y, Takii Y. Clinical impact of mesorectal extranodal cancer tissue in rectal cancer: detailed pathological assessment using whole-mount sections. Dis Colon Rectum. 2010;53(5):771–8.

    Article  PubMed  Google Scholar 

  22. Wang Y, Zhang J, Zhou M, et al. Poor prognostic and staging value of tumor deposit in locally advanced rectal cancer with neoadjuvant chemoradiotherapy. Cancer Med. 2019;8(4):1508–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Nagayoshi K, Ueki T, Nishioka Y, et al. Tumor deposit is a poor prognostic indicator for patients who have stage II and III colorectal cancer with fewer than 4 lymph node metastases but not for those with 4 or more. Dis Colon Rectum. 2014;57(4):467–74.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This material is based on work funded by the National Natural Science Foundation of China (No. 82172816) and the Zhejiang Provincial Natural Science Foundation of China (No. LY22H160021).

Author information

Authors and Affiliations

  1. Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Xuzhi Zheng MM, Wei Cen MM, Junchang Zhu MM & Lechi Ye MD

Authors
  1. Xuzhi Zheng MM
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wei Cen MM
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Junchang Zhu MM
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lechi Ye MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lechi Ye MD.

Ethics declarations

Disclosure

The authors have declared no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 860 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zheng, X., Cen, W., Zhu, J. et al. Prognostic Value of Tumor Deposits in Stage III Colorectal Cancer Patients with Different N Stages: A Population-Based, Retrospective, Cohort Study. Ann Surg Oncol 30, 8067–8073 (2023). https://doi.org/10.1245/s10434-023-14338-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-023-14338-x

Search

Navigation