title: Tumor deposits counted as positive lymph nodes in TNM staging for advanced colorectal cancer: a retrospective multicenter study.
abstract: We investigated the possibility of counting tumor deposits (TDs) as positive lymph nodes (pLNs) in the pN category and evaluated its prognostic value for colorectal cancer (CRC) patients. A new pN category (npN category) was calculated using the numbers of pLNs plus TDs. The npN category included 4 tiers: npN1a (1 tumor node), npN1b (2-3 tumor nodes), npN2a (4-6 tumor nodes), and npN2b (≥7 tumor nodes). We identified 4,121 locally advanced CRC patients, including 717 (11.02%) cases with TDs. Univariate and multivariate analyses were performed to evaluate the disease-free and overall survival (DFS and OS) for npN and pN categories. Multivariate analysis showed that the npN and pN categories were both independent prognostic factors for DFS (HR 1.614, 95% CI 1.541 to 1.673; HR 1.604, 95% CI 1.533 to 1.679) and OS (HR 1.633, 95% CI 1.550 to 1.720; HR 1.470, 95% CI 1.410 to 1.532). However, the npN category was superior to the pN category by Harrell's C statistic. We conclude that it is thus feasible to consider TDs as positive lymph nodes in the pN category when evaluating the prognoses of CRC patients, and the npN category is potentially superior to the TNM (7th edition) pN category for predicting DFS and OS among advanced CRC patients.
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: General Surgery Department, Sichuan Cancer Hospital/Institution, Chengdu, People's Republic of China.
authors.forename: Shengke
authors.initials: S
authors.lastname: Yang
authors.affiliation: Gastrointestinal Tumor Surgery Department, Hubei Cancer Hospital, Wuhan, People's Republic of China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Hu
authors.affiliation: General Surgery Department, 2nd Affiliated Hospital of Jilin University, Changchun, People's Republic of China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Internal Medicine-Oncology, Cancer Institute/Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
authors.forename: Feng
authors.initials: F
authors.lastname: Du
authors.affiliation: General Surgery Department, Xuzhou Central Hospital, Xuzhou, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yin
authors.affiliation: Surgical Department of Gastrointestinal Diseases, Youan Hospital of Capital Medical University, Beijing, People's Republic of China.
authors.forename: Sai
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Pathology, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Ci
authors.initials: C
authors.lastname: Li
authors.affiliation: Central Laboratory, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Shasha
authors.initials: S
authors.lastname: Xing
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Jiatian
authors.initials: J
authors.lastname: Yuan
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Lv
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Fan
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Shusheng
authors.initials: S
authors.lastname: Leng
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, People's Republic of China.
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
keywords: colorectal cancer; lymph nodes; tumor deposits