Tabanera Alberto Vilar, Alonso Manuel Díez, Allaoua Yousef, Casalduero Lucas, Moreno Fernando Mendoza, Mañes Félix, Matías Belén, Diego Lucía, Mansilla Cristina Vera, Bataller Laura Castellá, Diaz-Pedrero Raúl, Ortega Miguel A, de Mon Melchor Álvarez, Gutiérrez Alberto
Department of General and Digestive Surgery, University Hospital Príncipe de Asturias, 28805 Madrid, Spain.
Department of Surgery, Medical and Social Sciences. Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain.
Int J Med Sci. 2025 Jun 23;22(13):3162-3173. doi: 10.7150/ijms.113099. eCollection 2025.
Although tumor deposits (TD) have been known for almost a century, their origin and mode of spread remain controversial. The main objective is to analyze the prognostic value of tumor deposits in non-metastatic colorectal cancer as a risk factor of global recurrence, locoregional recurrence, liver and lung metastasis and specially for peritoneal metastasis (PM). : This study analyzed 1,425 non-metastatic colorectal cancer patients. Four groups were built, according to the presence or absence of Lymph Node Metastasis (LNM) or TD. : The global recurrence rate in patients with TDs was significantly higher than those without TDs (17.8% vs 60.8%; p<0.001). Patients with TDs had a lower survival and suffered higher rates of liver metastasis (8.6% vs 26.7%; p<0.001); OR of 4.244 (95% CI: 3.004-5.994) and lung metastasis (7.4% vs 19.3%; p<0.001); (OR 3.585;95% CI: 2.397-5.362). However, the main differences were found in PM (4.7 % vs 26.1 %; p<0.001); (OR: 7.511 (95% CI:5.092-11.079). Distribution by groups shows that patients with TD and LNM had a higher rate of PM. Patients with TD without any LMN had higher PM rate than those with LNM without TD. In stage III, patients with TD suffered higher rates of PM, (26.1% vs 10.9%); p< 0.001). OR: 3.075 (95% CI: 1.969-4.803). : The presence of TD increases the risk of peritoneal metastasis. Patients with TD without LNM had higher rate of peritoneal metastasis than those with LNM without TD. TD have independent prognostic value and provide complementary information. Prognostic value of TDs is underestimated in the current TNM system.
尽管肿瘤沉积物（TD）已被发现近一个世纪，但其起源和扩散方式仍存在争议。主要目的是分析肿瘤沉积物在非转移性结直肠癌中作为总体复发、局部区域复发、肝转移和肺转移尤其是腹膜转移（PM）风险因素的预后价值。：本研究分析了1425例非转移性结直肠癌患者。根据有无淋巴结转移（LNM）或TD构建了四组。：有TD的患者总体复发率显著高于无TD的患者（17.8%对60.8%；p<0.001）。有TD的患者生存率较低，肝转移率较高（8.6%对26.7%；p<0.001）；比值比为4.244（95%置信区间：3.004 - 5.994），肺转移率也较高（7.4%对19.3%；p<0.001）；（比值比3.585；95%置信区间：2.397 - 5.362）。然而，主要差异体现在PM方面（4.7%对26.1%；p<0.001）；（比值比：7.511（95%置信区间：5.092 - 11.079）。分组分布显示，有TD和LNM的患者PM发生率较高。无任何LMN的TD患者PM发生率高于有LNM但无TD的患者。在III期，有TD的患者PM发生率较高，（26.1%对10.9%）；p<0.001）。比值比：3.075（95%置信区间：1.969 - 4.803）。：TD的存在增加了腹膜转移的风险。无LNM的TD患者腹膜转移率高于有LNM但无TD的患者。TD具有独立的预后价值并提供补充信息。在当前的TNM系统中，TD的预后价值被低估。
