Abstract
PurposeTo evaluate the role of tumor deposits (TDs) in predicting the efficacy of chemotherapy in stage III colon cancer.MethodsUsing the SEER∗Stat software Version 8.3.6, we started with a national cohort of colon cancer cases diagnosed between 2004 and 2016. We used the χ2 (Chi-square) test to compare differences between different categorical variables according to the number of TDs. The Cox proportional hazards regression model was used to determine the independent association of different clinical and pathological variables with CSS, which were adjusted for other significant prognostic factors.ResultsWe have identified 29,017 patients diagnosed with stage III colon cancer from the SEER database. The results of multivariate analyses showed that patients with the receipt of chemotherapy had 54.7% decreased risk of cancer-specific mortality compared with those not (HR = 0.453, 95% CI = 0.425–0.483, P < 0.0001) in the no-TD group; In the 1–2-TD group, patients with the receipt of chemotherapy had 56.8% decreased risk of cancer-specific mortality compared with those not (HR = 0.432, 95% CI = 0.364–0.512, P < 0.0001); In the ≥3-TD group, patients with the receipt of chemotherapy had 51.8% decreased risk of cancer-specific mortality compared with those not (HR = 0.482, 95% CI = 0.389–0.597, P < 0.0001).ConclusionsOur study demonstrated that the presence of TDs was associated with a dismal prognosis and high number of TDs would also contribute to the worse survival of colon cancer. High number of TDs did not affect the survival benefit of chemotherapy in stage III colon cancer.
Highlights
Colon cancer is one of the most malignant tumors and occupies the fifth leading cause of cancer deaths worldwide [1]
Only qualified patients diagnosed with stage III colon cancer were included in this study, and all the patients were divided into three groups: no tumor deposit (TD) (N = 24740) vs. 1–2 TDs (N = 3103) vs. ≥3 TDs (N = 1174)
We have identified 29,017 patients diagnosed with stage III colon cancer with the known number of TDs from the SEER database, and all the patients were divided into three groups, including no TDs (N = 24740), 1–2 TDs (N = 3103), and ≥3 TDs (N = 1174)
Summary
Colon cancer is one of the most malignant tumors and occupies the fifth leading cause of cancer deaths worldwide [1]. It is reported that more than one-third of colon cancer patients would present with lymph node metastases, that is, stage III colon cancer. 5-Fluorouracil (5-FU)-based chemotherapy regimens are commonly used in stage III colon cancer followed by surgical resection of the primary tumor, and it is known that 50% of the stage III colon. In 1935, tumor deposit (TD) was firstly reported in some node-negative colorectal cancer patients after meticulous pathological dissection of colorectal cancer specimens, and the researchers believed that these non-lymphatic metastases were the result of vascular spread [7]. Tumor deposit was a discrete nodule of cancer in pericolic/perirectal fat or adjacent mesentery, without histological evidence of residual lymph node or identifiable vascular or neural structures [7, 8]
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