Clinical and morphological study of the prognostic value of tumor deposits in colorectal cancer

Currently, the presence of tumor deposits in colorectal cancer does not significantly affect the staging and their role in the prognosis of the disease is controversial. Objective. To study the clinical and morphological features and disease-free survival in patients with colorectal cancer (CRC) with tumor deposits (TD). Material and methods. The medical histories and histological material of 60 patients with CRC who were treated at the Sechenov University Clinical Center were retrospectively analyzed. The first group included 29 patients with stage III—IV of the disease, in whom, during morphological examination of the surgical material, TD were found in the paracolic/pararectal tissue. The second group consisted of 31 patients with stage III-IV disease without TD. The groups were compared by gender, age, stages (TNM), localization and degree of malignancy of the tumor, presence/absence of lymphatic, vascular and perineural invasion. Recurrence-free survival was studied for 36 months, both locoregional recurrences and distant metastases were taken into account. A statistical analysis of the data obtained was carried out. Results. It was found that in the group with TD in CRC, the chance of recurrence was 4.4 times (p=0.031) higher than in the group without deposits, and the average time to recurrence decreased, which was 26.1±13.2 months in group 1 (CRC with TD); 32.8±8.4 months in group 2 (CRC without TD) (p=0.013). It was found that tumors with TD are more often localized in the left half of the colon and rectum, have a large stage at the time of diagnosis, and perineural invasion is significantly more common (p=0.016). Conclusion. The study found that the presence of tumor deposits in the paracolic and pararectal tissue is an important prognostic factor and is associated with a decrease in disease-free survival in stage III-IV colorectal cancer.