Negative prognostic impact of tumor deposits in rectal cancer – a national study cohort
Agger, Erik LU
; Jörgren, Fredrik
LU
; Jöud, Anna
LU
; Lydrup, Marie-Louise
LU
and Buchwald, Pamela
LU
(2023)
In Annals of Surgery
273(3).
p.526-533
- Abstract
- Objective: To investigate whether tumor deposits (TDs) in rectal cancer are associated with
increased recurrence risk and decreased survival.
Summary background data: Tumor deposits (TDs) are considered a risk factor for
recurrence after colon cancer resection and presence of TDs prompts adjuvant chemotherapy.
The prognostic relevance of TDs in rectal cancer requires further exploration.
Methods: All patients treated with abdominal resection surgery for rectal cancer in Sweden
between 2011 and 2014 were eligible for inclusion in this retrospective cohort-study based on
prospectively collected data from the Swedish ColoRectal Cancer Registry. Primary endpoint
was local recurrence or distant metastasis.... (More) - Objective: To investigate whether tumor deposits (TDs) in rectal cancer are associated with
increased recurrence risk and decreased survival.
Summary background data: Tumor deposits (TDs) are considered a risk factor for
recurrence after colon cancer resection and presence of TDs prompts adjuvant chemotherapy.
The prognostic relevance of TDs in rectal cancer requires further exploration.
Methods: All patients treated with abdominal resection surgery for rectal cancer in Sweden
between 2011 and 2014 were eligible for inclusion in this retrospective cohort-study based on
prospectively collected data from the Swedish ColoRectal Cancer Registry. Primary endpoint
was local recurrence or distant metastasis. Secondary outcomes were overall and relative
survival.
Results: 5455 patients were identified. 3769 patients were analysed after exclusion. TDs were
found in 404 (10.7%) patients including where 140 (3.7%) patients with had N1c-status. In
TD-positive patients, local recurrence and distant metastasis rates at 5 years were 6.3% [95%
CI 3.8-8.8%] and 38.9% [95% CI, 33.6-43.5%] compared to 2.7% [95% CI, 2.1-3.3%] and
14.3% [95% CI, 13.1-15.5%] in TD-negative patients. In multivariable regression analysis,
risk of local recurrence and distant metastasis were increased; HR 1.86 [95% CI, 1.09-3.19;
P=0.024] and 1.87 [95% CI, 1.52-2.31; P=was 68.8% [95% CI, 64.4-73.4%] in TD-positive patients and 80.7% [95% CI, 79.4-82.1%] in
TD-negative patients. pN1c-patients had similar outcomes regarding local recurrence, distant
Copyright © 2022 Wolters Kluwer Health, Inc. Unauthorized reproduction of the article is prohibited.
ACCEPTED
metastasis and survival as pN1a-b stage patients. TD-positive pN1a-b patients had
significantly worse outcomes while TDs did not affect outcomes in pN2a-b patients.
Conclusion: This study suggests that TDs have a negative impact on prognosis in rectal
cancer. Thus, efforts should be made to diagnose TD-positive rectal cancer patients
preoperatively. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/363eca00-725a-4488-a6e1-565533e2c71c
- author
- Agger, Erik
LU
; Jörgren, Fredrik
LU
; Jöud, Anna
LU
; Lydrup, Marie-Louise
LU
and Buchwald, Pamela
LU
- organization
- publishing date
- 2023-08-10
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Surgery
- volume
- 273
- issue
- 3
- pages
- 526 - 533
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:36538637
- scopus:85149910725
- ISSN
- 1528-1140
- DOI
- 10.1097/SLA.0000000000005755
- language
- English
- LU publication?
- yes
- id
- 363eca00-725a-4488-a6e1-565533e2c71c
- date added to LUP
- 2023-03-10 15:49:30
- date last changed
- 2023-11-17 04:05:40
@article{363eca00-725a-4488-a6e1-565533e2c71c,
abstract = {{Objective: To investigate whether tumor deposits (TDs) in rectal cancer are associated with<br/>increased recurrence risk and decreased survival.<br/>Summary background data: Tumor deposits (TDs) are considered a risk factor for<br/>recurrence after colon cancer resection and presence of TDs prompts adjuvant chemotherapy.<br/>The prognostic relevance of TDs in rectal cancer requires further exploration.<br/>Methods: All patients treated with abdominal resection surgery for rectal cancer in Sweden<br/>between 2011 and 2014 were eligible for inclusion in this retrospective cohort-study based on<br/>prospectively collected data from the Swedish ColoRectal Cancer Registry. Primary endpoint<br/>was local recurrence or distant metastasis. Secondary outcomes were overall and relative<br/>survival.<br/>Results: 5455 patients were identified. 3769 patients were analysed after exclusion. TDs were<br/>found in 404 (10.7%) patients including where 140 (3.7%) patients with had N1c-status. In<br/>TD-positive patients, local recurrence and distant metastasis rates at 5 years were 6.3% [95%<br/>CI 3.8-8.8%] and 38.9% [95% CI, 33.6-43.5%] compared to 2.7% [95% CI, 2.1-3.3%] and<br/>14.3% [95% CI, 13.1-15.5%] in TD-negative patients. In multivariable regression analysis,<br/>risk of local recurrence and distant metastasis were increased; HR 1.86 [95% CI, 1.09-3.19;<br/>P=0.024] and 1.87 [95% CI, 1.52-2.31; P=was 68.8% [95% CI, 64.4-73.4%] in TD-positive patients and 80.7% [95% CI, 79.4-82.1%] in<br/>TD-negative patients. pN1c-patients had similar outcomes regarding local recurrence, distant<br/>Copyright © 2022 Wolters Kluwer Health, Inc. Unauthorized reproduction of the article is prohibited.<br/>ACCEPTED<br/>metastasis and survival as pN1a-b stage patients. TD-positive pN1a-b patients had<br/>significantly worse outcomes while TDs did not affect outcomes in pN2a-b patients.<br/>Conclusion: This study suggests that TDs have a negative impact on prognosis in rectal<br/>cancer. Thus, efforts should be made to diagnose TD-positive rectal cancer patients<br/>preoperatively.}},
author = {{Agger, Erik and Jörgren, Fredrik and Jöud, Anna and Lydrup, Marie-Louise and Buchwald, Pamela}},
issn = {{1528-1140}},
language = {{eng}},
month = {{08}},
number = {{3}},
pages = {{526--533}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Annals of Surgery}},
title = {{Negative prognostic impact of tumor deposits in rectal cancer – a national study cohort}},
url = {{http://dx.doi.org/10.1097/SLA.0000000000005755}},
doi = {{10.1097/SLA.0000000000005755}},
volume = {{273}},
year = {{2023}},
}