A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study

Abstract Introduction Local recurrence and distant metastasis after curative surgery and chemotherapy for colorectal cancer (CRC) is a serious complication and is considered a failure of the therapeutic strategy. The aim of this study is to identify the different prognostic factors associated with t...

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Main Authors: Ahmed Bendari, Ebubekir Ucar, Alaa Bendari, Hamed Hammoud, FNU Kiran, Reham Al-Refai, Sunder Sham, Sanjay Kirshan Kumar, Ryan Des Jean, Manju Harshan
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Surgical and Experimental Pathology
Online Access:https://doi.org/10.1186/s42047-024-00173-1
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author Ahmed Bendari
Ebubekir Ucar
Alaa Bendari
Hamed Hammoud
FNU Kiran
Reham Al-Refai
Sunder Sham
Sanjay Kirshan Kumar
Ryan Des Jean
Manju Harshan
author_facet Ahmed Bendari
Ebubekir Ucar
Alaa Bendari
Hamed Hammoud
FNU Kiran
Reham Al-Refai
Sunder Sham
Sanjay Kirshan Kumar
Ryan Des Jean
Manju Harshan
author_sort Ahmed Bendari
collection DOAJ
description Abstract Introduction Local recurrence and distant metastasis after curative surgery and chemotherapy for colorectal cancer (CRC) is a serious complication and is considered a failure of the therapeutic strategy. The aim of this study is to identify the different prognostic factors associated with tumor recurrence and distant metastasis in CRC. Design An analytical cross-sectional design was employed, and our hospital clinical and pathology databases were queried for non-metastatic CRC (stage I-III). Patients were included if they underwent surgery and chemotherapy between 01/2016 to 12/2018 and demographic information, tumor characteristics and postoperative outcomes were extracted from each case. The data were entered into a database using SPSS version 21. Univariate analysis was initially performed, followed by a multivariate analysis to develop a prognostic model for tumor recurrence and distant metastasis in CRC. Result A total of 138 non-metastatic CRC patients were enrolled in this study. The demographic characteristics of all patients are summarized in Table 1. Our study included 65 male and 73 female patients with a Median (IQR) age of 69 (17.7) years. Among the cases, 91 (65.9%) patients had no recurrence, and 47 (34.1%) patients developed a recurrence during follow-up. Univariate analysis revealed that positive lymph nodes (p = 0.03) and tumor deposits ≥ 4 (p = 0.04) were significantly associated with colorectal tumor recurrence and/or metastasis. However, variables such as age, sex, smoking, alcohol consumption, family history of CRC, PNI, LVI, tumor size, and histological features like mucinous or signet ring cell morphology did not show any statistical significance (p > 0.05). Multivariate analysis adjusted for age, lymph node status, and tumor deposits, identified that tumor deposits ≥ 4 was the only predictor of tumor recurrence following colorectal surgery and chemotherapy. Conversely, positive lymph node status did not show statistical significance (p = 0.3). Further analysis revealed that patients who had tumor deposit number ≥ 4 tend to experience local recurrence/distant metastasis more than patients with tumor deposit number < 4. Conclusion In non-metastatic CRC patients, TD ≥ 4 is a strong predictor of local tumor recurrence and distant metastasis. Based on these findings, patients who have TDs in primary CRC resection should be subjected to enhanced surveillance.
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spelling doaj-art-1ad0d70728e546c7a9e24eb36fbeb71c2025-01-12T12:14:01ZengBMCSurgical and Experimental Pathology2520-84542025-01-01711710.1186/s42047-024-00173-1A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center studyAhmed Bendari0Ebubekir Ucar1Alaa Bendari2Hamed Hammoud3FNU Kiran4Reham Al-Refai5Sunder Sham6Sanjay Kirshan Kumar7Ryan Des Jean8Manju Harshan9Department of Pathology and Laboratory Medicine, Lenox Hill HospitalDepartment of Pathology and Laboratory Medicine, Long Island Jewish HospitalDepartment of Medical Biochemistry, Faculty of Medicine, Zagazig UniversityQatar Metabolic Institute, Hamad Medical CorporationDepartment of Pathology and Laboratory Medicine, Staten Island HospitalDepartment of Pathology and Laboratory Medicine, Lenox Hill HospitalDepartment of Pathology and Laboratory Medicine, Lenox Hill HospitalDepartment of Medicine and Allied, Bahria University Health SciencesDepartment of Pathology and Laboratory Medicine, Lenox Hill HospitalDepartment of Pathology and Laboratory Medicine, Lenox Hill HospitalAbstract Introduction Local recurrence and distant metastasis after curative surgery and chemotherapy for colorectal cancer (CRC) is a serious complication and is considered a failure of the therapeutic strategy. The aim of this study is to identify the different prognostic factors associated with tumor recurrence and distant metastasis in CRC. Design An analytical cross-sectional design was employed, and our hospital clinical and pathology databases were queried for non-metastatic CRC (stage I-III). Patients were included if they underwent surgery and chemotherapy between 01/2016 to 12/2018 and demographic information, tumor characteristics and postoperative outcomes were extracted from each case. The data were entered into a database using SPSS version 21. Univariate analysis was initially performed, followed by a multivariate analysis to develop a prognostic model for tumor recurrence and distant metastasis in CRC. Result A total of 138 non-metastatic CRC patients were enrolled in this study. The demographic characteristics of all patients are summarized in Table 1. Our study included 65 male and 73 female patients with a Median (IQR) age of 69 (17.7) years. Among the cases, 91 (65.9%) patients had no recurrence, and 47 (34.1%) patients developed a recurrence during follow-up. Univariate analysis revealed that positive lymph nodes (p = 0.03) and tumor deposits ≥ 4 (p = 0.04) were significantly associated with colorectal tumor recurrence and/or metastasis. However, variables such as age, sex, smoking, alcohol consumption, family history of CRC, PNI, LVI, tumor size, and histological features like mucinous or signet ring cell morphology did not show any statistical significance (p > 0.05). Multivariate analysis adjusted for age, lymph node status, and tumor deposits, identified that tumor deposits ≥ 4 was the only predictor of tumor recurrence following colorectal surgery and chemotherapy. Conversely, positive lymph node status did not show statistical significance (p = 0.3). Further analysis revealed that patients who had tumor deposit number ≥ 4 tend to experience local recurrence/distant metastasis more than patients with tumor deposit number < 4. Conclusion In non-metastatic CRC patients, TD ≥ 4 is a strong predictor of local tumor recurrence and distant metastasis. Based on these findings, patients who have TDs in primary CRC resection should be subjected to enhanced surveillance.https://doi.org/10.1186/s42047-024-00173-1
spellingShingle Ahmed Bendari
Ebubekir Ucar
Alaa Bendari
Hamed Hammoud
FNU Kiran
Reham Al-Refai
Sunder Sham
Sanjay Kirshan Kumar
Ryan Des Jean
Manju Harshan
A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study
Surgical and Experimental Pathology
title A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study
title_full A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study
title_fullStr A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study
title_full_unstemmed A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study
title_short A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study
title_sort high number of tumor deposits ≥ 4 is an isolated predictor of local recurrence and distant metastasis in non metastatic colorectal cancer a single center study
url https://doi.org/10.1186/s42047-024-00173-1
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