Prognostic impact and independent significance of tumor deposits in early-stage colon cancer: a population-based cohort study
International Journal of Colorectal Disease, cilt.40, sa.1, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 40 Sayı: 1
- Basım Tarihi: 2025
- Doi Numarası: 10.1007/s00384-025-04908-8
- Dergi Adı: International Journal of Colorectal Disease
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
- Anahtar Kelimeler: Colorectal cancer, Overall survival, Prognostic factor, Tumor deposits
- Süleyman Demirel Üniversitesi Adresli: Evet
Özet
Background: Tumor deposits (TD) are well-established prognostic markers in advanced-stage colorectal cancer (CRC), but their independent significance in early-stage disease remains unclear. Current staging systems do not account for TD in node-negative CRC, despite emerging evidence suggesting a potential impact on survival. This study aimed to assess the prognostic impact of TD in early-stage (T1-T3, N0) colon cancer using a large population-based cohort and advanced statistical methods. Methods: A retrospective cohort study was conducted using the SEER database (2010–2021), including 111,106 patients with early-stage (T1–T3) colon cancer, of whom 4055 (3.6%) were TD-positive. To minimize baseline imbalances, propensity score matching (1:3 nearest-neighbor; caliper = 0.2) was applied. Overall survival (OS) and disease-specific survival (DSS) were assessed using the Kaplan–Meier analysis and compared with log-rank tests. Multivariate Cox regression was performed to evaluate the independent prognostic impact of TD status in both unmatched and matched cohorts. Results: TD-positive patients demonstrated significantly worse overall survival (OS) and disease-specific survival (DSS) compared to TD-negative patients (log-rank p < 0.001). In the unmatched cohort, TD positivity was independently associated with reduced OS (HR: 1.56, 95% CI: 1.48–1.65) and DSS (HR: 2.33, 95% CI: 2.14–2.54; both p < 0.001). These associations remained significant after propensity score matching (OS: HR: 1.44, 95% CI: 1.35–1.54; DSS: HR: 2.17, 95% CI: 1.97–2.40; both p < 0.001). Conclusion: TD is an independent prognostic factor in early-stage colon cancer, warranting closer surveillance and reconsideration of treatment strategies. These findings suggest that TD should be integrated into risk stratification models, challenging current staging paradigms.