Published online Mar 21, 2023. doi: 10.3748/wjg.v29.i11.1735
Peer-review started: December 3, 2022
First decision: December 19, 2022
Revised: January 2, 2023
Accepted: March 3, 2023
Article in press: March 3, 2023
Published online: March 21, 2023
Colorectal cancer is a frequent cause of cancer-related mortality in patients with lymph node or distant metastases. Pericolonic tumor deposits (TDs) are considered prognostically distinct from lymph node metastases.
To investigate risk factors for extranodal TDs in stage III colon cancer.
This was a retrospective cohort study. We selected 155 individuals diagnosed with stage III colon cancer from the database of the Cancer Registry of the Tri-Service General Hospital. The patients were allocated into the groups with/without N1c. Multivariate Cox regression analysis and Kaplan-Meier method were done. The primary outcomes investigate the association between the covariates and extranodal TDs, and prognostic significance of the covariates regarding the survival.
There were 136 individuals in the non-N1c group and 19 individuals in the N1c group. Patients with lymphovascular invasion (LVI) had a higher risk of TDs. Overall survival rates of patients with and without LVI were 6.64 years and 8.61 years, respectively (P = 0.027). The N1c patients without LVI had higher overall survival than those who with LVI (7.73 years vs 4.42 years, P = 0.010).
Patients having stage III colon cancer with LVI have a higher probability of having TDs than those with stage III colon cancer without LVI. Stage III colon cancer patients with TDs and LVI could have poor prognosis and outcome.
Core Tip: Tumor deposits has been associated with poor outcome in patient with colorectal cancer. In our study, we investigated the risk factors predicting extranodal tumor deposits in stage III colorectal cancer patients according to the new American Joint Committee on Cancer TNM staging and helped pathologist not to miss the subgroup of N1c patients. Sincerely, we look forward to more robust therapeutic approach and closer survivorship planning for this subgroup of high-risk stage III colon cancer patients in the future.