Patients with colon cancer whose tumor deposits had a single anatomical access point showed significantly better 5-year survival rates than those with multiple access points.
In a study published in Pathology, researchers examined the relationship between anatomical access points of tumor deposits (TD) and prognosis in colon carcinoma by evaluating 280 TD from 127 patients who underwent resection at Radboud University Medical Centre between 1986 and 2012. Immunohistochemical staining using CD34, D2-40, S100, and elastic van Gieson was applied to identify access to surrounding anatomical structures, including blood vessels, lymphatic vessels, and peripheral nerves. Of the 280 TD, 112 (40 percent) showed multiple access points, 109 (39 percent) showed a single access point, and 59 (21 percent) showed no identifiable access point.
Haematovascular invasion (HVI) was identified in 57 percent of TD, lymphovascular invasion in 39 percent, and peripheral nerve invasion in 36 percent. Among TD with multiple access points, HVI was present in 93 percent of cases. A statistically significant association was observed between TD size and number of access points (p<0.001), with larger TD more frequently exhibiting multiple access points.
Survival analysis was conducted by the researchers at Radboud University Medical Center, Nijmegen on a subset of patients with available data: overall survival (OS) was calculated for 84 patients and disease-free survival (DFS) for 88 patients. Patients with TD characterized by a single access point had higher 5-year OS (51 percent) compared with those with two (26 percent) or three (29 percent) access points (p=0.025). Similarly, 5-year DFS was 36 percent for the single access group and 16 percent and 21 percent for the two and three access point groups, respectively (p=0.005). No significant differences were found between clinicopathological characteristics and the number of access points.
A portion of TD (21 percent) could not be assigned to a specific access point group. This outcome is consistent with prior research in which a subset of TD remained unclassified despite extensive sectioning. The current study used multiple immunohistochemical stains to improve classification.
The data showed that most TD were associated with at least one anatomical structure, with HVI being the most common. An increased number of access points was associated with reduced OS and DFS. These findings provide additional data for the characterization of TD in colon cancer.
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