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Tumour deposits are a significant prognostic factor in gastric cancer – a systematic review and meta‐analysis
Author(s) -
Graham Martínez Cristina,
Knijn Nikki,
Verheij Marcel,
Nagtegaal Iris D,
Post Rachel S
Publication year - 2019
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13781
Subject(s) - medicine , cancer , hazard ratio , relative risk , confidence interval , multivariate analysis , oncology , lymphovascular invasion , lymph node , proportional hazards model , meta analysis , univariate analysis , gastroenterology , risk factor , lymphatic system , metastasis , pathology
Aims Tumour deposits ( TD s) are clusters of cancer cells in the soft tissue that are discontinuous from the primary tumour. In this review we are exploring their relevance for prognosis in patients with gastric cancer. Methods and results A literature search was performed to identify studies providing data on TD s and prognosis in gastric cancer patients. Eight papers were included in the meta‐analysis, which was carried out in terms of risk ratios ( RR ) and hazard ratios ( HR ) with 95% confidence interval (95% CI ). Of 7445 patients, 1551 had TD s (20.9%). TD s were associated with a decreased overall survival ( OS ) in univariate ( HR = 2.82, 95% CI = 1.9–4.3) and multivariate analyses ( HR = 1.65, 95% CI = 1.3–2.1). TD s were also associated with known prognostic factors such as synchronous metastatic disease ( RR = 9.5), invasion depth ( RR = 1.8), lymph node metastasis ( RR = 1.7), lymphatic invasion ( RR = 1.7), vascular invasion ( RR = 2.6) and poor differentiation ( RR = 1.2). Conclusions We found a strong indication that TD s are independent predictors of prognosis in patients with gastric cancer; hence, TD s should be included in the staging of gastric cancers.