Abstract
BackgroundThe presence and the prognostic significance of perigastric tumor deposits (TDs) in primary gastric cancer have not been extensively studied. The aim of this study was to evaluate the prognostic significance perigastric TDs in primary gastric cancer.MethodsFrom 2005 to 2010, 1250 patients underwent R0 gastrectomy at the Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China. Out of 1250 patients, 132 patients with perigastric TDs were identified. Additionally, 132 patients with staged matched gastric cancer without tumor deposits were selected as a control group.ResultsPerigastric TDs were observed in 132 (10.5%) of the 1250 patients with gastric cancer who underwent R0 gastrectomy. There were 94 males (71.21%) and 38 females (28.79%) (2.47:1). The mean age was 57.21 years. Clinicopathologic characteristics between the two groups matched well. There was a significant difference in the overall survival of those with and without TDs by univariate (p<0.05) and multivariate (p < 0.05) survival analysis. The 1-, 3-and 5-year overall survival rates of patients with TDswere69.6%, 39.3%, and 24.2%, respectively, and were significantly poorer than those of the staged matched control group. There was no correlation between the number of TDs and patient survival in patients with gastric cancer (p>0.05); however, when comparing each pT tumor group with the perigastric TD group, the stage T4 survival rate was very similar to that observed in patients with TDs.ConclusionsPerigastric TDs are an independent predictive prognostic factor for gastric cancer and may be appropriately considered a form of serosal invasion. We suggest that TDs should be included in TNM staging system for better outcomes.
Highlights
The presence and the prognostic significance of perigastric tumor deposits (TDs) in primary gastric cancer have not been extensively studied
Clinicopathologic features such as gender, age at the time of diagnosis, differentiation type, size, location, American Joint Committee on Cancer (AJCC) primary tumor (pT) category, the number of node metastases, AJCC the number of metastatic lymph nodes (pN) category, and the type of operation were compared between the patients with and without TDs
There was no correlation between the number of TDs and patient survival in patients with gastric cancer (p > 0.05) (Additional file 3: Fig. S1)
Summary
The presence and the prognostic significance of perigastric tumor deposits (TDs) in primary gastric cancer have not been extensively studied. The aim of this study was to evaluate the prognostic significance perigastric TDs in primary gastric cancer. Tumor deposits (TDs), first recognized by Gabriel in 1935 [4],are defined as cluster of peritumoral nodules in the peritumoral adipose tissue of a primary carcinoma without histologic evidence of residual lymph node in the nodule. These may represent discontinuous spread, venous invasion with the extravascular spread, or a totally replaced lymph node [2]. Puppa et al reported that TDs were not limited to colorectal cancers, but were common in other tumor types including biliary duct, ovarian, gastric and pancreatic cancers [10]
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