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Ann Surg. 2012 Feb;255(2):208-13. doi: 10.1097/SLA.0b013e31821ad8a2.

Is the seventh edition of the UICC/AJCC TNM staging system reasonable for patients with tumor deposits in colorectal cancer?

Author information

1
Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Shenyang, People's Republic of China.

Abstract

OBJECTIVE:

To assess the rationality of the seventh edition of TNM staging system on tumor deposits (TDs) and propose a novel subclassification.

SUMMARY BACKGROUND DATA:

The TDs had been debated for many years. The seventh edition of TNM staging system proposed a "pN1c" concept. However, the value of the modification is still debated.

METHODS:

A total of 1541 patients with colorectal cancer were reviewed. Overall survival rates were compared between patients without LNM but TD (+), and those who were TD (-). The TDs were stratified into the "any T + any N" category. Two-step multivariate analysis was performed to identify significant prognostic factors. Univariate analysis was used to determine whether a correlation existed between the number of TDs and prognosis.

RESULTS:

There was a significant prognostic difference between patients without LNM or TDs compared with those with positive TDs. Only in T3N2bM0 there was a significant prognostic difference between LNM (+), TD (+) patients and TD (-) patients. The seventh edition of TNM staging system was substituted by the novel TNM staging system in 2-step multivariate analysis. Only in T3N1cM0 there was a significant prognostic difference between patients with only 1 TD and those with more than 1 TD.

CONCLUSION:

The seventh edition of TNM staging system on TDs satisfactorily predicts patients' outcome for those without LNM. Patients who categorized as T3N2bM0TD (+) and T4N2bM0TD (-/+) should be reclassified as stage IV. Number of TDs was not an independent prognostic parameter in the TNM staging system.

PMID:
21527844
DOI:
10.1097/SLA.0b013e31821ad8a2
[Indexed for MEDLINE]

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