Peritumoral deposits as an adverse prognostic indicator of colorectal cancer

Am J Surg. 2014 Jan;207(1):70-7. doi: 10.1016/j.amjsurg.2013.04.009. Epub 2013 Oct 7.

Abstract

Background: The aim of this study was to determine the prognostic value of peritumoral deposits (PTDs) in colorectal cancer (CRC).

Methods: A total of 695 patients with pT3/T4 CRC (1980 to 1999) were reviewed. Tumor deposits located ≥2 mm from the front of the direct spread in the primary tumor were evaluated as PTDs.

Results: PTDs were observed in 111 patients (16.0%). The incidence of PTDs increased according to increasing N stage: 7% for N0, 22% for N1, and 39% for N2 (P < .0001). Five-year disease-specific survival was 85.0% in patients without PTDs and 59.5% in those with PTDs (P < .0001). Multivariate analysis showed that PTDs affected disease-specific survival independent of T and N stages. A significant prognostic impact of PTDs was similarly observed in another cohort comprising 474 patients with pT3/T4 CRC (2000 to 2005). The κ values among 8 observers were .70 for PTDs and .32 for the conventional growth pattern.

Conclusions: PTDs have considerable prognostic relevance and offer improved judgment reproducibility in assessing the invasive margin of CRC.

Keywords: Colorectal cancer; Growth pattern; Invasive margin; Peritumoral deposits; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Disease-Free Survival
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors