Author:
Pu Hongjiang,Pang Xiaolin,Fu Jiangping,Zheng Rui,Chen Yaxue,Zhang Dafu,Fang Xiangdong
Abstract
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) who 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 tumor 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) were 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.
Funder
the National Natural Science Foundation of China
Innovative scientific research project of medical youth in Sichuan Province
the Scientific Research Fund of Technology Bureau in Dazhou
the scientific fund of Health Commission of Sichuan Province
Publisher
Springer Science and Business Media LLC
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