Study Of Tumor Deposits’ Application In Postoperative Pathologic Staging Definition And The Prognostic Value In Colorectal Cancer Patients

Objective Our study aims to investigate the relationship between postoperative pathological tumor deposits and the prognosis of patients with colorectal cancer surgery,concluding a detailed and reasonable method in tumor staging.Methods 361 patients from January 2012 to December 2013 received surgical therapy in the general surgery department of the first affiliated hospital of Anhui Medical University were involved in our study.We explored their clinical characteristics and the follow-up outcomes.We used Kaplan-Meier survival curves to analyze the relevant factors’impact on the prognosis of patients with CRC.Results Postoperative tumor deposits positive or not was related to the degree of tumor differentiation,tumor infiltration depth（T）,p TNM,CEA and CA19-9,founding statistical significance（all P<0.05）.The survival time of patients with tumor deposits negative was higher than that of patients with tumor deposits positive in univariate ananlysis（?²=10.805,P<0.05）.After analyzing,we found that patients with stage N1and N1c having no survival different（?²=0.580,P>0.05）.However,when the number of tumor deposits was increasing,the survival prognosis of patients was getting worse.When the tumor deposits were treated as metastatic lymph nodes,modified staging was obtained and having statistical difference from the 8^thediting TNM staging.When it comes to the number of tumor deposits,metastatic lymph nodes number and the detected total lymph nodes number,we found that patients with high positive nodes ratio（tumor deposits+metastatic lymph nodes）/（total number of all nodes）have bad survival outcomes（59.4 vs.58.2 vs.36.0 vs.28.7,?²=15.389,P=0.002）.Conclusions Tumor deposits status are the important factor affecting the prognosis of patients with CRC.When we defining positive tumor deposits and metastatic lymph nodes as positive nodes,the patients with high positive nodes ratio would have bad prognosis.Positive nodes ratio can be used as important supplement for TNM staging of CRC patients,providing a more accurate basis for guiding treatment in the future.