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Tumor Deposits in Stage III Colon Cancer: Correlation With Other Histopathologic Variables, Prognostic Value, and
Victor E Pricolo1,2, Jon Steingrimsson3, Tracey J McDuffie4
1Departments of Surgery.
Tumor deposits (TDs) significantly impact stage III colon cancer survival. High-risk factors like T4, N2, and poor differentiation worsen outcomes, necessitating refined risk stratification for better patient management.
Area of Science:
- Oncology
- Gastroenterology
- Cancer Research
Background:
- National Comprehensive Cancer Network (NCCN) guidelines stratify stage III colon cancer risk using T and N status.
- Accurate risk stratification is crucial for tailoring treatment and improving patient outcomes in stage III colon cancer.
Purpose of the Study:
- To analyze the prognostic impact of tumor deposits (TDs) and other histopathologic factors on survival in stage III colon cancer.
- To evaluate the role of TDs, T and N status, poor differentiation (PD), perineural invasion (PNI), and lymphovascular invasion (LVI) in predicting survival.
Main Methods:
- Retrospective analysis of 42,901 stage III colon cancer patients from the National Cancer Database (2010-2015).
- Inclusion criteria: treatment with surgery and chemotherapy.
- Statistical analysis included log-rank tests for Kaplan-Meier curves and Cox proportional hazard models.
Main Results:
- Tumor deposits (TDs) were associated with significantly worse 5-year survival (41.5%) compared to patients without TDs (58.2%-59.8%).
- Presence of TDs correlated with adverse factors: T4 (36.9%), N2 (55.1%), PD (37.4%), PNI (34.5%), and LVI (69.1%).
- Hazard ratios indicated increased mortality risk: TD (1.34), T4 (1.71), N2 (1.44), PD (1.37), PNI (1.11), LVI (1.18).
Conclusions:
- Tumor deposits are a significant independent prognostic factor in stage III colon cancer.
- The findings support enhanced risk stratification beyond current NCCN and AJCC classifications.
- Consideration of new classifications (e.g., N2c) may improve management and survivorship strategies for patients with TDs.
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