RESUMEN
Objective:To explore the effect of tumor deposit (TD) on the prognosis of patients with stage Ⅲ colon cancer after radical resection.Methods:The clinicopathological data of patients with stage Ⅲ colon cancer after radical surgery at the Department of Gastrointestinal Surgery, Peking University People's Hospital from Jan to Dec 2015 were analyzed collected. Clinicopathological characteristics such as tumor location, degree of differentiation, mismatch repair status, lymphatic and venous invasion, and preoperative CEA and CA19-9 levels were used to study the effect of TD on the postoperative survival of patients.Results:Among the 155 patients with stage Ⅲ colon cancer, 37 (23.9%) had tumor deposits. The incidence of tumor deposits was higher in patients with intravascular tumor thrombus and preoperative serum CA19-9 elevation ( χ2=9.567, P=0.002; χ2=11.561, P=0.003); Patients with tumor deposits had worse overall survival and disease-free survival than those without cancer nodules (OS: P=0.029, DFS: P=0.025). Multivariate COX analysis found that tumor deposit was an independent risk factor for postoperative overall survival and disease-free survival ( HR=1.990, 95% CI: 1.032-3.835, P=0.040; HR=2.416, 95% CI : 1.205-3.820, P=0.009). Conclusions:Tumor deposit is an independent risk factor affecting postoperative overall survival and disease-free survival in patients with stage Ⅲ colon cancer. For patients with lymph node metastasis, incorporating TD into TNM staging can more accurately predict the postoperative prognosis.
RESUMEN
Objective: To evaluate the prognostic impact of tumor deposits on the overall survival (OS) of gastric cancer (GC) patients. Methods: Between January 2007 and December 2012, 312 GC patients undergoing curative resection in The First Affiliated Hospital of Hainan Medical University were enrolled. Patients were categorized into two groups based on the tumor deposit status of postopera-tive pathology: positive group, presence of tumor deposits and negative group, absence of tumor deposits. The correlations of tumor deposit status with clinicopathological and potential prognostic factors were analyzed. Results: Eighty-four (26.9%) patients had tumor deposits. There were significant differences in Borrmann type, tumor size, depth of invasion, N stage, tumor-node-metastasis (TNM) stage, and lymphovascular invasion between the two groups on univariate analysis. Multivariate analysis revealed that Borrmann type, N stage, and lymphovascular invasion were independently associated with the presence of tumor deposits. In univariate survival analy-sis, age, tumor location, Borrmann type, tumor size, TNM stage, type of gastrectomy, lymphovascular invasion, and presence of tumor deposits were found to be significant prognostic factors. GC patients with tumor deposits had a significantly lower 5-year OS rate than those without tumor deposits (5-year OS: 34.5% vs . 67.5% , P<0.001). Multivariate analysis revealed that age, Borrmann type III/IV, TNM stage, lymphovascular invasion, and presence of tumor deposits were independent prognostic factors for this cohort. Further stratified analysis demonstrated that the significant prognostic differences between the two groups were only observed in patients with stage N0-3a disease. There were no significant differences in survival between patients with and without tumor deposits at the N3b stage. The prognosis of GC patients with tumor deposits was independently correlated with N stage, lymphovascular invasion, and postoperative chemotherapy. Conclusions: The presence of tumor deposits was an independent prognostic factor in GC patients and can be used as a prognostic indicator for GC patients with stage N0-3a disease. GC patients with tumor deposits should receive postop-erative chemotherapy regardless of TNM stage.