title: Prognostic value of tumour deposit and perineural invasion status in colorectal cancer patients: a SEER-based population study.
abstract: OBJECTIVE
  The definition of tumour deposit (TD) in colorectal cancer (CRC) was changed recently in the American Joint Commission on Cancer (AJCC) Staging Manual, 7th edition. We aimed to examine the prognostic values of the newly defined TD and perineural invasion (PNI) in this population study.
  
  
  RESULTS
  We identified the incidental CRC cases with known TD or PNI status in the Surveillance, Epidemiology, and End Results (SEER) programme diagnosed in 2010 and 2011. Kaplan-Meier survival analysis and multivariable Cox proportional hazards models were used to estimate overall survivals (OS) and cancer-specific survival (CSS). We found that 6.71% (2774 of 41 323) of the CRC cases were positive for TD and 9.61% (3970 of 41 215) positive for PNI. In multivariable models, TD- and PNI-positive statuses correlated independently with worse 3-year OS [hazard ratio (HR): 1.68, 95% confidence interval (CI): 1.58-1.80 and HR: 1.24, 95%: CI: 1.16-1.32, respectively] and 3-year CSS (HR: 1.79, 95% CI: 1.65-1.94 and HR: 1.28, 95% CI: 1.18-1.38, respectively, P < 0.001 for all). Other independent prognostic factors included age, T category, N category, tumour location and tumour grade, but not gender. TD and PNI correlated with worse OS in all N categories (P < 0.001 for all). TD-associated HR for 3-year OS increases as the N category becomes lower (1.73 in N2, 2.32 in N1 and 3.24 in N0), while rare (1.4%) TD-positive CRC in N0 category should have been assigned to N1c.
  
  
  CONCLUSIONS
  Tumour deposit and PNI correlate independently with worse 3-year OS and CSS. TD appears prognostically more important in the CRC of lower N categories.
authors.affiliation: Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Mayo
authors.affiliation: Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.|Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
authors.forename: Adana A M
authors.initials: AA
authors.lastname: Llanos
authors.affiliation: Department of Pathology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Yi
authors.affiliation: Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
authors.forename: Sheng-Zhong
authors.initials: SZ
authors.lastname: Duan
authors.affiliation: Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.|Department of Pathology, University Medical Center of Princeton, Plainsboro, NJ, USA.|Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA.|Department of Pathology, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA.
authors.forename: Lanjing
authors.identifier: http://orcid.org/0000-0001-5436-887X
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D033162:Incidental Findings; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010525:Peripheral Nerves / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D018426:SEER Program
keywords: colorectal cancer; perineural invasion; prognosis; racial disparity; survival; tumour deposit