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Am J Surg. 2014 Jan;207(1):70-7. doi: 10.1016/j.amjsurg.2013.04.009. Epub 2013 Oct 7.

Peritumoral deposits as an adverse prognostic indicator of colorectal cancer.

Author information

1
Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan. Electronic address: ueno@ndmc.ac.jp.
2
Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
3
Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan.
4
Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan.
5
Laboratory for Mathematics, National Defense Medical College, Tokorozawa, Japan; Laboratory for Statistical Analysis, Center for Genomic Medicine, RIKEN, Yokohama, Japan.

Abstract

BACKGROUND:

The aim of this study was to determine the prognostic value of peritumoral deposits (PTDs) in colorectal cancer (CRC).

METHODS:

A total of 695 patients with pT3/T4 CRC (1980 to 1999) were reviewed. Tumor deposits located ≥2 mm from the front of the direct spread in the primary tumor were evaluated as PTDs.

RESULTS:

PTDs were observed in 111 patients (16.0%). The incidence of PTDs increased according to increasing N stage: 7% for N0, 22% for N1, and 39% for N2 (P < .0001). Five-year disease-specific survival was 85.0% in patients without PTDs and 59.5% in those with PTDs (P < .0001). Multivariate analysis showed that PTDs affected disease-specific survival independent of T and N stages. A significant prognostic impact of PTDs was similarly observed in another cohort comprising 474 patients with pT3/T4 CRC (2000 to 2005). The κ values among 8 observers were .70 for PTDs and .32 for the conventional growth pattern.

CONCLUSIONS:

PTDs have considerable prognostic relevance and offer improved judgment reproducibility in assessing the invasive margin of CRC.

KEYWORDS:

Colorectal cancer; Growth pattern; Invasive margin; Peritumoral deposits; Prognosis

PMID:
24112678
DOI:
10.1016/j.amjsurg.2013.04.009
[Indexed for MEDLINE]

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