Investigators assessed whether adding tumor deposit status to colorectal cancer staging may enhance prognostication, according to a recent study published by Sassun et al in JAMA Surgery.
Background
In patients undergoing surgical treatment of colorectal cancer, tumor deposits are defined as discrete tumor nodules located in the pericolorectal adipose tissue within a lymph drainage area discontinuous from the primary tumor. Although these deposits are discovered in up to 20% of patients and are associated with poorer oncologic outcomes, the presence of these deposits is not currently included in staging systems unless lymph node metastases are documented.
Study Methods and Results
In this study, the investigators used data from institutional and national databases to evaluate the outcomes of 788 patients staged using lymph node status combined with tumor deposit status compared with 77,790 patients staged according to standard American Joint Committee on Cancer (AJCC) staging.
The investigators demonstrated that the new staging system provided superior overall survival stratification. Further, 17.1% of patients were found to be understaged when the conventional AJCC staging system was used.
Conclusions
In an accompanying editorial, published by Abbas and Chu in JAMA Surgery, investigators underscored that the strength of the current study included external validation using a large national database, high prognostic discrimination, and important insights regarding the impact of under staging.
The investigators recommended that tumor deposits be included in future staging systems for colorectal cancer.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
