DOI: 10.59518/farabimedj.1999807 ISSN: 2979-9821

Clinicopathologic Significance of Tumor Deposits in Colon Adenocarcinoma: Associations with Regional Tumor Burden and Adverse Invasive Features

Ömer Atmış, Sema Ocak, Hanife Seda Mavili, Fatma Seher Pehlivan, Ayça Tan, Semin Ayhan
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Objective: To evaluate whether tumor deposit presence was associated with histologically confirmed regional lymph node metastasis in colon adenocarcinoma. Associations with other clinicopathologic features, tumor deposit count, and overall survival were evaluated as secondary or exploratory objectives. Material and Methods: This retrospective cohort study included 191 patients who underwent colon resection for adenocarcinoma. Rectal tumors, neoadjuvant-treated cases, and non-resection specimens were excluded. Tumor deposit data were extracted from the original pathology reports, in which deposits had been classified according to College of American Pathologists criteria, and were analyzed by presence and count (0, 1, or ≥2). Histologically confirmed lymph node metastasis was defined as the primary outcome. Associations with other clinicopathologic features were considered secondary, whereas tumor deposit count-based, subgroup, alternative nodal classification, and overall survival analyses were considered exploratory. Results: Tumor deposits were identified in 35 of 191 patients (18.3%). Compared with tumor deposit-negative cases, tumor deposit-positive tumors more often showed histologically confirmed lymph node metastasis, extramural venous invasion, lymphovascular invasion, perineural invasion, serosal involvement, and advanced pathological T stage. Exploratory count-based analyses showed associations with metastatic lymph node burden and PNI after FDR correction. The weak overall correlation with tumor budding count did not persist when the analysis was restricted to tumor deposit-positive patients. In the exploratory node-positive subgroup, no association remained significant after FDR correction. Tumor deposits were associated with shorter overall survival in univariable analysis; however, an independent association could not be demonstrated after adjustment for the selected clinical and pathological factors. Conclusion: Tumor deposits in colon adenocarcinoma were associated with histologically confirmed lymph node metastasis and several adverse invasive features. None of the examined associations met the FDR-adjusted significance threshold in the exploratory node-positive subgroup. Although tumor deposit status was associated with shorter overall survival in univariable analysis, an independent association could not be demonstrated after adjustment for the selected factors. The limited number of deaths and relatively short follow-up preclude excluding a clinically relevant independent effect.

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