Int J Colorectal Dis. 2025 Jun 26;40(1):146. doi: 10.1007/s00384-025-04908-8.
ABSTRACT
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.
PMID:40563004 | DOI:10.1007/s00384-025-04908-8
