Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis
Purpose The presence of tumor deposits (TDs) in colorectal cancer is associated with a poor prognosis. In patients with the concomitant presence of both TDs and lymph nodes (LNs), there is no staging option except for the number of positive LNs alone. Therefore, to determine the prognostic value of...
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| Veröffentlicht in: | International journal of colorectal disease 2022, Vol.37 (1), p.141-151 |
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| container_title | International journal of colorectal disease |
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| creator | Moon, Jae Young Lee, Min Ro Ha, Gi Won |
| description | Purpose
The presence of tumor deposits (TDs) in colorectal cancer is associated with a poor prognosis. In patients with the concomitant presence of both TDs and lymph nodes (LNs), there is no staging option except for the number of positive LNs alone. Therefore, to determine the prognostic value of TDs in patients with stage III colorectal cancer, meta-analyses of survival outcomes of patients with TDs were performed comparing different subgroups based on the lymph node status.
Methods
PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effect models. Outcome measures were 5-year overall survival (OS) and 5-year disease-free survival (DFS).
Results
We included in the analysis 18 nonrandomized studies and 1 prospective study that examined 90,455 patients. N1c patients (TD + LN-) had worse 5-year DFS than TDs-negative stage III patients (TD-LN +) with a RR of 1.30 (95% CI 1.06–1.61,
I
2
= 47%). In subgroup analysis, N1c patients had worse 5-year DFS (RR = 1.60, 95% CI = 1.25–2.05,
I
2
= 40%) compared with TDs-negative N1 patients (TD-N1) whereas N1c patients had better 5-year OS (RR = 0.72, 95% CI = 0.62–0.83,
I
2
= 0%) and 5-year DFS (RR = 0.75, 95% CI = 0.57–0.99,
I
2
= 0%) compared with TDs-negative N2 patients (TD-N2).
Conclusions
These results may suggest that current nodal staging for colorectal cancer needs modification. The presence of TDs may have more adverse oncologic outcomes than TDs-negative N1 patients. More studies are warranted to further verify these results. |
| doi_str_mv | 10.1007/s00384-021-04036-z |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2578774243</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714487071</galeid><sourcerecordid>A714487071</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-6bd194cf51087a4771e2a7994edd43e3a6da95fbfdaa0451997694da3702ccb3</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhSMEokPhBVggS2zYpPgvccyuqvgZqVK76N6649wEV4k92E6r6YvwuniYQgWqKi-sa3_n3Gv5VNVbRk8YpepjolR0sqac1VRS0dZ3z6oVk4LXjLf8ebWiTOma6aY7ql6ldE1L3Sr5sjoSstFN0zWr6udlDKMPKTtLbmBakISB5GUOkfS4DcnlRIZSTMGPdcY4k-BtmMJY-LBkG2ZMxHmyhezQF_jW5e8kZRiRrNdrsmcj2gwTseAtxk8ESNqljDPse0a8cXhLwPdkxgw1eJh2yaXX1YsBpoRv7vfj6urL56uzb_X5xdf12el5baXkuW43PdPSDg2jnQKpFEMOSmuJfS8FCmh70M2wGXoAKhumtWq17EEoyq3diOPqw8F2G8OPBVM2s0sWpwk8hiUZ3qhOKcmlKOj7_9DrsMQybqFappUslvqBGmFC4_wQcgS7NzWniknZKapYoU4eocrqcXY2eBxcOf9HwA8CG0NKEQezjW6GuDOMmn0YzCEMpoTB_A6DuSuid_cTL5sZ-7-SP79fAHEAUrnyI8aHJz1h-wt1X8Eq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2619747029</pqid></control><display><type>article</type><title>Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Moon, Jae Young ; Lee, Min Ro ; Ha, Gi Won</creator><creatorcontrib>Moon, Jae Young ; Lee, Min Ro ; Ha, Gi Won</creatorcontrib><description>Purpose
The presence of tumor deposits (TDs) in colorectal cancer is associated with a poor prognosis. In patients with the concomitant presence of both TDs and lymph nodes (LNs), there is no staging option except for the number of positive LNs alone. Therefore, to determine the prognostic value of TDs in patients with stage III colorectal cancer, meta-analyses of survival outcomes of patients with TDs were performed comparing different subgroups based on the lymph node status.
Methods
PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effect models. Outcome measures were 5-year overall survival (OS) and 5-year disease-free survival (DFS).
Results
We included in the analysis 18 nonrandomized studies and 1 prospective study that examined 90,455 patients. N1c patients (TD + LN-) had worse 5-year DFS than TDs-negative stage III patients (TD-LN +) with a RR of 1.30 (95% CI 1.06–1.61,
I
2
= 47%). In subgroup analysis, N1c patients had worse 5-year DFS (RR = 1.60, 95% CI = 1.25–2.05,
I
2
= 40%) compared with TDs-negative N1 patients (TD-N1) whereas N1c patients had better 5-year OS (RR = 0.72, 95% CI = 0.62–0.83,
I
2
= 0%) and 5-year DFS (RR = 0.75, 95% CI = 0.57–0.99,
I
2
= 0%) compared with TDs-negative N2 patients (TD-N2).
Conclusions
These results may suggest that current nodal staging for colorectal cancer needs modification. The presence of TDs may have more adverse oncologic outcomes than TDs-negative N1 patients. More studies are warranted to further verify these results.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-021-04036-z</identifier><identifier>PMID: 34595585</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Cancer ; Cancer patients ; Care and treatment ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - pathology ; Extranodal Extension ; Gastroenterology ; Hepatology ; Humans ; Internal Medicine ; Lymph nodes ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Medical prognosis ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Meta-analysis ; Neoplasm Staging ; Original Article ; Patient outcomes ; Proctology ; Prognosis ; Prospective Studies ; Retrospective Studies ; Surgery ; Survival ; Tumor staging ; Tumors</subject><ispartof>International journal of colorectal disease, 2022, Vol.37 (1), p.141-151</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>COPYRIGHT 2022 Springer</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-6bd194cf51087a4771e2a7994edd43e3a6da95fbfdaa0451997694da3702ccb3</citedby><cites>FETCH-LOGICAL-c442t-6bd194cf51087a4771e2a7994edd43e3a6da95fbfdaa0451997694da3702ccb3</cites><orcidid>0000-0001-9401-1760</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-021-04036-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-021-04036-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34595585$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moon, Jae Young</creatorcontrib><creatorcontrib>Lee, Min Ro</creatorcontrib><creatorcontrib>Ha, Gi Won</creatorcontrib><title>Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
The presence of tumor deposits (TDs) in colorectal cancer is associated with a poor prognosis. In patients with the concomitant presence of both TDs and lymph nodes (LNs), there is no staging option except for the number of positive LNs alone. Therefore, to determine the prognostic value of TDs in patients with stage III colorectal cancer, meta-analyses of survival outcomes of patients with TDs were performed comparing different subgroups based on the lymph node status.
Methods
PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effect models. Outcome measures were 5-year overall survival (OS) and 5-year disease-free survival (DFS).
Results
We included in the analysis 18 nonrandomized studies and 1 prospective study that examined 90,455 patients. N1c patients (TD + LN-) had worse 5-year DFS than TDs-negative stage III patients (TD-LN +) with a RR of 1.30 (95% CI 1.06–1.61,
I
2
= 47%). In subgroup analysis, N1c patients had worse 5-year DFS (RR = 1.60, 95% CI = 1.25–2.05,
I
2
= 40%) compared with TDs-negative N1 patients (TD-N1) whereas N1c patients had better 5-year OS (RR = 0.72, 95% CI = 0.62–0.83,
I
2
= 0%) and 5-year DFS (RR = 0.75, 95% CI = 0.57–0.99,
I
2
= 0%) compared with TDs-negative N2 patients (TD-N2).
Conclusions
These results may suggest that current nodal staging for colorectal cancer needs modification. The presence of TDs may have more adverse oncologic outcomes than TDs-negative N1 patients. More studies are warranted to further verify these results.</description><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Extranodal Extension</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Meta-analysis</subject><subject>Neoplasm Staging</subject><subject>Original Article</subject><subject>Patient outcomes</subject><subject>Proctology</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Tumor staging</subject><subject>Tumors</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAUhSMEokPhBVggS2zYpPgvccyuqvgZqVK76N6649wEV4k92E6r6YvwuniYQgWqKi-sa3_n3Gv5VNVbRk8YpepjolR0sqac1VRS0dZ3z6oVk4LXjLf8ebWiTOma6aY7ql6ldE1L3Sr5sjoSstFN0zWr6udlDKMPKTtLbmBakISB5GUOkfS4DcnlRIZSTMGPdcY4k-BtmMJY-LBkG2ZMxHmyhezQF_jW5e8kZRiRrNdrsmcj2gwTseAtxk8ESNqljDPse0a8cXhLwPdkxgw1eJh2yaXX1YsBpoRv7vfj6urL56uzb_X5xdf12el5baXkuW43PdPSDg2jnQKpFEMOSmuJfS8FCmh70M2wGXoAKhumtWq17EEoyq3diOPqw8F2G8OPBVM2s0sWpwk8hiUZ3qhOKcmlKOj7_9DrsMQybqFappUslvqBGmFC4_wQcgS7NzWniknZKapYoU4eocrqcXY2eBxcOf9HwA8CG0NKEQezjW6GuDOMmn0YzCEMpoTB_A6DuSuid_cTL5sZ-7-SP79fAHEAUrnyI8aHJz1h-wt1X8Eq</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Moon, Jae Young</creator><creator>Lee, Min Ro</creator><creator>Ha, Gi Won</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9401-1760</orcidid></search><sort><creationdate>2022</creationdate><title>Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis</title><author>Moon, Jae Young ; Lee, Min Ro ; Ha, Gi Won</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-6bd194cf51087a4771e2a7994edd43e3a6da95fbfdaa0451997694da3702ccb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Extranodal Extension</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Meta-analysis</topic><topic>Neoplasm Staging</topic><topic>Original Article</topic><topic>Patient outcomes</topic><topic>Proctology</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Survival</topic><topic>Tumor staging</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moon, Jae Young</creatorcontrib><creatorcontrib>Lee, Min Ro</creatorcontrib><creatorcontrib>Ha, Gi Won</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moon, Jae Young</au><au>Lee, Min Ro</au><au>Ha, Gi Won</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2022</date><risdate>2022</risdate><volume>37</volume><issue>1</issue><spage>141</spage><epage>151</epage><pages>141-151</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
The presence of tumor deposits (TDs) in colorectal cancer is associated with a poor prognosis. In patients with the concomitant presence of both TDs and lymph nodes (LNs), there is no staging option except for the number of positive LNs alone. Therefore, to determine the prognostic value of TDs in patients with stage III colorectal cancer, meta-analyses of survival outcomes of patients with TDs were performed comparing different subgroups based on the lymph node status.
Methods
PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effect models. Outcome measures were 5-year overall survival (OS) and 5-year disease-free survival (DFS).
Results
We included in the analysis 18 nonrandomized studies and 1 prospective study that examined 90,455 patients. N1c patients (TD + LN-) had worse 5-year DFS than TDs-negative stage III patients (TD-LN +) with a RR of 1.30 (95% CI 1.06–1.61,
I
2
= 47%). In subgroup analysis, N1c patients had worse 5-year DFS (RR = 1.60, 95% CI = 1.25–2.05,
I
2
= 40%) compared with TDs-negative N1 patients (TD-N1) whereas N1c patients had better 5-year OS (RR = 0.72, 95% CI = 0.62–0.83,
I
2
= 0%) and 5-year DFS (RR = 0.75, 95% CI = 0.57–0.99,
I
2
= 0%) compared with TDs-negative N2 patients (TD-N2).
Conclusions
These results may suggest that current nodal staging for colorectal cancer needs modification. The presence of TDs may have more adverse oncologic outcomes than TDs-negative N1 patients. More studies are warranted to further verify these results.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34595585</pmid><doi>10.1007/s00384-021-04036-z</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9401-1760</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | International journal of colorectal disease, 2022, Vol.37 (1), p.141-151 |
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| subjects | Analysis Cancer Cancer patients Care and treatment Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - pathology Extranodal Extension Gastroenterology Hepatology Humans Internal Medicine Lymph nodes Lymph Nodes - pathology Lymphatic Metastasis Medical prognosis Medical research Medicine Medicine & Public Health Medicine, Experimental Meta-analysis Neoplasm Staging Original Article Patient outcomes Proctology Prognosis Prospective Studies Retrospective Studies Surgery Survival Tumor staging Tumors |
| title | Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis |
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