title: Tumor deposit is a poor prognostic indicator for patients who have stage II and III colorectal cancer with fewer than 4 lymph node metastases but not for those with 4 or more.
abstract: BACKGROUND
  Extranodal tumor deposits are involved in TNM classification. However, it is uncertain whether a tumor deposit is a regular lymph node metastasis, and its prognostic significance in patients with stage II or III colorectal cancer remains to be established.
  
  
  OBJECTIVE
  This study aimed to determine the prognostic significance of tumor deposits for stage II and III colorectal cancer.
  
  
  METHODS
  This study is a retrospective review of clinicopathological data.
  
  
  METHODS
  This study was conducted at a tertiary care hospital/referral center in Japan.
  
  
  METHODS
  We reviewed the clinical course of 171 stage II and 173 stage III consecutive patients between January 1999 and December 2006.
  
  
  METHODS
  We examined the clinicopathological features of colorectal cancers with tumor deposits and calculated overall survival and recurrence-free survival of the patients according to the status of tumor deposits. The primary outcome was the impact of tumor deposits on patient survival.
  
  
  RESULTS
  Thirty-five (10.2%) patients with colorectal cancers had tumor deposits in the pericolic and/or mesocolic region. Survival rates among the patients with tumor deposits were significantly lower than those without (5-year overall survival: 58.4% vs 81.0%, p < 0.0001; 5-year recurrence-free survival: 47.1% vs 73.4%, p < 0.0001). Tumor deposit was an independent prognostic factor for patients with colorectal cancer in multivariate analysis (overall survival: HR, 2.30; 95% CI, 1.26-4.04; p = 0.04; recurrence-free survival: HR, 2.42; 95% CI, 1.04-4.90; p = 0.04). Tumor deposit was an independent prognostic factor in N0 and N1 colorectal cancer, whereas N2 cancer had poor survival outcome regardless of tumor deposit.
  
  
  CONCLUSIONS
  Our study was a single-institution retrospective study, and the numbers of patients were relatively small to draw firm conclusions.
  
  
  CONCLUSIONS
  Tumor deposit may be an independent adverse prognostic factor for stage II and III N1 colorectal cancer.
authors.affiliation: 1Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 2Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Kinuko
authors.initials: K
authors.lastname: Nagayoshi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueki
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Nishioka
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Manabe
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mizuuchi
authors.forename: Minako
authors.initials: M
authors.lastname: Hirahashi
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Oda
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome