Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2023; 29(11): 1735-1744
Published online Mar 21, 2023. doi: 10.3748/wjg.v29.i11.1735
Risk factors predict microscopic extranodal tumor deposits in advanced stage III colon cancer patients
Yi-Han Jhuang, Yu-Ching Chou, Yu-Chun Lin, Je-Ming Hu, Ta-Wei Pu, Chao-Yang Chen
Yi-Han Jhuang, Division of Cardiovascular Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Yu-Ching Chou, School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
Yu-Chun Lin, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Je-Ming Hu, Chao-Yang Chen, Division of Colorectal Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Ta-Wei Pu, Division of Colorectal Surgery, Tri-Service General Hospital Song-shan Branch, National Defense Medical Center, Taipei 114, Taiwan
Author contributions: Jhuang YH contributed to conceptualization, data curation, formal analysis, investigation, methodology, validation, and writing original draft; Chou YC contributed to methodology, software and supervision; Lin YC, Hu JM, and Pu TW contributed to data collection; Chen CY contributed to supervision, validation, review and editing.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board (IRB) of TSGH (Approval No. C202005173).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Data can be acquired from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Chao-Yang Chen, MD, Assistant Professor, Division of Colorectal Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325 Chang-gong Road, Nei-Hu District, Taipei 114, Taiwan.
Received: December 3, 2022
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
Processing time: 103 Days and 21.4 Hours

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.

Keywords: Colon cancer, Tumor deposits, Lymphovascular invasion, Risk factor

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.