Tumour deposits in colon cancer predict recurrence and reduced survival in a nationwide population-based study
Jörgren, Fredrik LU ; Agger, Erik LU
; Lydrup, Marie-Louise
LU
and Buchwald, Pamela
LU
(2023)
In BJS Open
7(6).
- Abstract
- Background: Tumour deposits are suggested to impact prognosis in colon cancer negatively. This study assessed the impact of tumour deposits on oncological outcomes.
Methods: Data from the Swedish Colorectal Cancer Registry for patients who underwent R0 abdominal surgery for TNM stage I-III colon cancer between 2011 and 2014 with 5-year follow-up were analysed with multivariable analysis. Patients were categorized for their tumour deposit status and compared for the local recurrence and distant metastasis rates and 5-year survivals (overall and relative). Subgroup analyses were performed according to the nodal disease status.
Results: Of 8146 stage I-III colon cancer patients who underwent R0 resection, 8014 patients were... (More) - Background: Tumour deposits are suggested to impact prognosis in colon cancer negatively. This study assessed the impact of tumour deposits on oncological outcomes.
Methods: Data from the Swedish Colorectal Cancer Registry for patients who underwent R0 abdominal surgery for TNM stage I-III colon cancer between 2011 and 2014 with 5-year follow-up were analysed with multivariable analysis. Patients were categorized for their tumour deposit status and compared for the local recurrence and distant metastasis rates and 5-year survivals (overall and relative). Subgroup analyses were performed according to the nodal disease status.
Results: Of 8146 stage I-III colon cancer patients who underwent R0 resection, 8014 patients were analysed (808 tumour deposits positive, 7206 tumour deposits negative). Patients with tumour deposits positive tumours had increased local recurrence and distant metastasis rates (7.2 versus 3.0 per cent; P < 0.001 and 33.9 versus 12.0 per cent; P < 0.001 respectively) and reduced 5-year overall and relative survival (56.8 per cent versus 74.9 per cent; P < 0.001 and 68.5 versus 92.6 per cent; P < 0.001 respectively). In multivariable analysis, tumour deposits moderately increased the risks of local recurrence and distant metastasis (hazard ratio 1.50, 95 per cent c.i. 1.09 to 2.07; P = 0.013 and HR 1.91, 95 per cent c.i. 1.64 to 2.23; P < 0.001 respectively) and worse 5-year overall and relative survival (hazard ratio 1.60, 95 per cent c.i. 1.40 to 1.82; P < 0.001 and excess hazard ratio 2.24, 95 per cent c.i. 1.81 to 2.78; P < 0.001 respectively). Subgroup analysis of N stages found that N1c patients had worse outcomes than N0 for distant metastasis and relative survival. For patients with lymph node metastases tumour deposits increased the risks of distant metastasis and worse overall and relative survival, except for N2b patients.
Conclusion: Tumour deposits negatively impact the prognosis in colon cancer and must be considered when discussing adjuvant chemotherapy. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/bc289d55-307b-4e96-9269-0b070ecbc3b4
- author
- Jörgren, Fredrik
LU
; Agger, Erik
LU
; Lydrup, Marie-Louise
LU
and Buchwald, Pamela
LU
- organization
- publishing date
- 2023-11-30
- type
- Contribution to journal
- publication status
- published
- subject
- in
- BJS Open
- volume
- 7
- issue
- 6
- article number
- zrad122
- publisher
- Wiley
- external identifiers
-
- pmid:38035752
- scopus:85178519280
- ISSN
- 2474-9842
- DOI
- 10.1093/bjsopen/zrad122
- language
- English
- LU publication?
- yes
- id
- bc289d55-307b-4e96-9269-0b070ecbc3b4
- date added to LUP
- 2023-12-02 11:11:12
- date last changed
- 2024-01-02 04:02:55
@article{bc289d55-307b-4e96-9269-0b070ecbc3b4,
abstract = {{Background: Tumour deposits are suggested to impact prognosis in colon cancer negatively. This study assessed the impact of tumour deposits on oncological outcomes.<br/><br/>Methods: Data from the Swedish Colorectal Cancer Registry for patients who underwent R0 abdominal surgery for TNM stage I-III colon cancer between 2011 and 2014 with 5-year follow-up were analysed with multivariable analysis. Patients were categorized for their tumour deposit status and compared for the local recurrence and distant metastasis rates and 5-year survivals (overall and relative). Subgroup analyses were performed according to the nodal disease status.<br/><br/>Results: Of 8146 stage I-III colon cancer patients who underwent R0 resection, 8014 patients were analysed (808 tumour deposits positive, 7206 tumour deposits negative). Patients with tumour deposits positive tumours had increased local recurrence and distant metastasis rates (7.2 versus 3.0 per cent; P < 0.001 and 33.9 versus 12.0 per cent; P < 0.001 respectively) and reduced 5-year overall and relative survival (56.8 per cent versus 74.9 per cent; P < 0.001 and 68.5 versus 92.6 per cent; P < 0.001 respectively). In multivariable analysis, tumour deposits moderately increased the risks of local recurrence and distant metastasis (hazard ratio 1.50, 95 per cent c.i. 1.09 to 2.07; P = 0.013 and HR 1.91, 95 per cent c.i. 1.64 to 2.23; P < 0.001 respectively) and worse 5-year overall and relative survival (hazard ratio 1.60, 95 per cent c.i. 1.40 to 1.82; P < 0.001 and excess hazard ratio 2.24, 95 per cent c.i. 1.81 to 2.78; P < 0.001 respectively). Subgroup analysis of N stages found that N1c patients had worse outcomes than N0 for distant metastasis and relative survival. For patients with lymph node metastases tumour deposits increased the risks of distant metastasis and worse overall and relative survival, except for N2b patients.<br/><br/>Conclusion: Tumour deposits negatively impact the prognosis in colon cancer and must be considered when discussing adjuvant chemotherapy.}},
author = {{Jörgren, Fredrik and Agger, Erik and Lydrup, Marie-Louise and Buchwald, Pamela}},
issn = {{2474-9842}},
language = {{eng}},
month = {{11}},
number = {{6}},
publisher = {{Wiley}},
series = {{BJS Open}},
title = {{Tumour deposits in colon cancer predict recurrence and reduced survival in a nationwide population-based study}},
url = {{http://dx.doi.org/10.1093/bjsopen/zrad122}},
doi = {{10.1093/bjsopen/zrad122}},
volume = {{7}},
year = {{2023}},
}