Volume 26, Issue 3 pp. 459-465
ORIGINAL ARTICLE

Tumour deposits are independently associated with recurrence in colon cancer

Lynn Hakki

Lynn Hakki

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Conceptualization, Writing - original draft, Formal analysis, Methodology, ​Investigation

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Asama Khan

Asama Khan

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Conceptualization, Formal analysis, Writing - original draft, Methodology, ​Investigation

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Eric Do

Eric Do

Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Formal analysis, Conceptualization, Writing - original draft, Methodology, ​Investigation

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Mithat Gonen

Mithat Gonen

Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Conceptualization, Formal analysis, Writing - original draft, Methodology, ​Investigation

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Canan Firat

Canan Firat

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: ​Investigation

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Efsevia Vakiani

Efsevia Vakiani

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: ​Investigation

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Jinru Shia

Jinru Shia

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: ​Investigation

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Maria Widmar

Maria Widmar

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Writing - review & editing, Resources

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Iris H. Wei

Iris H. Wei

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Writing - review & editing, Resources

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J. Joshua Smith

J. Joshua Smith

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Writing - review & editing, Resources

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Emmanouil P. Pappou

Emmanouil P. Pappou

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Writing - review & editing, Resources

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Garrett M. Nash

Garrett M. Nash

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Writing - review & editing, Resources

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Philip B. Paty

Philip B. Paty

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Writing - review & editing, Resources

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Julio Garcia-Aguilar

Julio Garcia-Aguilar

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Contribution: Writing - review & editing, Resources

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Martin R. Weiser

Corresponding Author

Martin R. Weiser

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

Correspondence

Martin R. Weiser, Colorectal Service, Department of Surgery, 1275 York Ave., New York, NY, USA.

Email: [email protected]

Contribution: Conceptualization, Writing - original draft, Formal analysis, ​Investigation, Methodology

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First published: 23 January 2024

Meeting presentation: podium presentation at the American Society of Colon and Rectal Surgeons Annual Scientific Meeting, 3–6 June 2023, Seattle, Washington.

Abstract

Aim

Tumour deposits are focal aggregates of cancer cells in pericolic fat and mesentery, distinct from vessels, nerves and lymphatics. Their presence upstages lymph node negative patients but is ignored in lymph node positive patients. We investigated the clinicopathological factors associated with tumour deposits and their impact on recurrence in lymph node positive and negative patients.

Method

Clinicopathological variables were collected from the medical records of patients with Stage I–III colon cancer who underwent resection in 2017–2019. Pathology was reviewed by a gastrointestinal pathologist. Patients with rectal cancer, metastasis, and concurrent malignancy were excluded.

Results

Tumour deposits were noted in 69 (9%) of 770 patients. They were associated with the presence of lymph node metastasis, advanced T category, poorly differentiated tumours, microsatellite stable subtype and lymphovascular and perineural invasion (p < 0.05). The presence of tumour deposits (hazard ratio 2.48, 95% CI 1.49–4.10) and of lymph node metastasis (hazard ratio 3.04, 95% CI 1.72–5.37) were independently associated with decreased time to recurrence. There was a weak correlation (0.27) between the number of tumour deposits and the number of positive lymph nodes.

Conclusion

Tumour deposits are associated with more advanced disease and high-risk pathological features. The presence of tumour deposits and lymph node metastasis were found to be independent risk factors for decreased time to recurrence. A patient with both lymph node metastasis and tumour deposits is more than twice as likely to have recurrence compared with a patient with only lymph node metastasis. Tumour deposits independently predict recurrence and should not be ignored in lymph node positive patients.

CONFLICT OF INTEREST STATEMENT

None.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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