Nasrin Sarkhani, Bahareh Mehramuz, Ali Akbar Shekarchi, Sajad Sarkhani, Maryam Jafarzadeh, Elham Sarkhani
TDs were observed in a considerable proportion of GC cases and were associated with more aggressive pathological features and poorer survival. They may improve prognostic stratification, but further validation in larger multicenter studies is required.
BACKGROUND: Tumor deposits (TDs) are recognized as adverse prognostic factors in colorectal cancer and are incorporated as N1c in the TNM staging system. Their significance in gastric cancer (GC), however, remains less clear.
OBJECTIVE: This study aimed to investigate the association of TDs with pathological features and survival outcomes in GC.
METHODS: We conducted a cross-sectional study of patients with pathologically confirmed GC treated at two tertiary hospitals in Tabriz, Iran, between January 2020 and December 2024. Clinical and pathological data, including tumor characteristics and survival status, were collected for the participants. TDs and their characteristics were also evaluated. Associations between the presence of TDs and clinicopathological features were analyzed using logistic regression models, while overall survival was assessed using Kaplan-Meier analysis and Cox proportional hazards regression.
RESULTS: The study included 256 patients (mean age 60.7±12.3 years; 61.3% male). TDs were present in 111 patients (43.4%). In multivariable analysis, pT category (OR=7.44, 95%CI: 2.22-24.89), pN category (OR=4.63, 95%CI: 1.97-10.86), and perineural invasion (OR=5.65, 95%CI: 2.40-13.29) were significant correlates of TDs. Kaplan-Meier analysis showed 1-, 3-, and 5-year overall survival rates of 93.7%, 75.7%, and 64.9%, respectively. Patients without TDs had significantly better survival compared to those with TDs (log-rank P<0.001). In multivariable Cox regression analysis, histological subtype (HR=2.07, 95%CI: 1.21-3.52), pT category (HR=4.68, 95%CI: 1.37-16.00), pN category (HR=2.79, 95%CI: 1.21-6.46), and the presence of TDs (HR=2.00, 95%CI: 1.06-3.75) were identified as independent predictors of poorer overall survival.
CONCLUSION: TDs were observed in a considerable proportion of GC cases and were associated with more aggressive pathological features and poorer survival. They may improve prognostic stratification, but further validation in larger multicenter studies is required.