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Prognostic value of tumor deposits in rectal cancer: A monocentric series of 505 patients
Author(s) -
Benoit Olivier,
Svrcek Magali,
Creavin Ben,
Bouquot Morgane,
Challine Alexandre,
Chafai Najim,
Debove Clotilde,
Voron Thibault,
Parc Yann,
Lefevre Jeremie H.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26165
Subject(s) - medicine , perineural invasion , colorectal cancer , stage (stratigraphy) , mesorectum , lymph node metastasis , gastroenterology , cancer , lymph node , adenocarcinoma , metastasis , total mesorectal excision , paleontology , biology
Background and Objectives It has been suggested that tumor deposits (TDs) may have a worse prognosis in rectal cancer compared with colonic cancer. The aim of this study was to assess TDs prognosis in rectal cancer. Methods Patients who underwent total mesorectum excision for rectal adenocarcinoma (2011‐2016) were included. A case‐matched analysis was performed to assess the accurate impact of TDs for each pN category after exclusion of synchronous metastasis. Results A total of 505 patients were included. TDs were observed in 99 (19.6%) patients, (pN1c = 37 [7.3%]). TDs were associated with pT3‐T4 stage ( P = .037), synchronous metastasis ( P = .003), lymph node (LN) invasion ( P = .041), vascular invasion ( P = .001), and perineural invasion ( P < .001). TD was associated with a worse 3‐year disease‐free survival (DFS) among pN0 (51.2% vs 79.8%; P < .001); pN1 patients (35.2% vs 70.1%; P = .004) but not among pN2 patients (37.5% vs 44.7%; P = .499). After matching, pN1c patients had a worse 3‐year DFS compared with pN0 patients (58.6% vs 82.4%; P = .035) and a tendency toward a worse DFS among N1 patients (40.1% vs 64.2%; P = .153). DFS was worse when one TD was compared with one invaded LN (40.8% vs 81.3%; P < .001). Conclusion In rectal cancer, TDs have a metastatic risk comparable to a pN2 stage which may lead to changes in adjuvant treatment.