Prognostic value of tumor deposits in rectal cancer: A monocentric series of 505 patients - Sorbonne Université
Journal Articles Journal of Surgical Oncology Year : 2020

Prognostic value of tumor deposits in rectal cancer: A monocentric series of 505 patients

Abstract

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.
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Dates and versions

hal-02961795 , version 1 (08-10-2020)

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Olivier Benoit, Magali Svrcek, Ben Creavin, Morgane Bouquot, Alexandre Challine, et al.. Prognostic value of tumor deposits in rectal cancer: A monocentric series of 505 patients. Journal of Surgical Oncology, In press, ⟨10.1002/jso.26165⟩. ⟨hal-02961795⟩
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