28: Tumor Deposits Are Associated with a Higher Risk of Peritoneal Disease in Non-Metastatic Colorectal Cancer Patients

Thursday, March 23, 2023

11:26 AM – 11:36 AM

Location: Ballroom C

Abstract Presenter(s)

Hamza Khan, MD

Resident
Valley Health System
Las Vegas, Nevada, United States

Disclosure(s): No financial relationships to disclose

First Author(s)

Hamza Khan, MD

Resident
Valley Health System
Las Vegas, Nevada, United States

Disclosure(s): No financial relationships to disclose

Author(s)

Shannon N. Radomski, MD (she/her/hers)

Resident
Department of Surgery, Johns Hopkins Hospital
Baltimore, Maryland, United States

Disclosure(s): No financial relationships to disclose
AS

Amn Siddiqi, MD

Research Associate
Johns Hopkins University Department of Surgery, United States

Disclosure information not submitted.
NZ

Nancy Zhou, BS

Medical Student
Johns Hopkins University School of Medicine, United States

Disclosure information not submitted.
Fabian M. Johnston, MD, MHS

Associate Professor of Surgery
Johns Hopkins University
Baltimore, Maryland, United States

Disclosure information not submitted.
Jonathan B. Greer, MD

Assistant Professor of Surgery and Oncology
Johns Hopkins University School of Medicine
Baltimore, Maryland, United States

Disclosure information not submitted.

Disclosure(s):

Hamza Khan, MD: No financial relationships to disclose

Shannon N. Radomski, MD: No financial relationships to disclose

Introduction:

Tumor deposits (TD) are a poor prognostic factor however the risk of peritoneal failure in colorectal cancer (CRC) patients is not well studied. This study aimed to determine whether TD carry the same risk of peritoneal recurrence as other known high-risk (HR) features in patients with CRC .

Methods:

We conducted a retrospective cohort study to evaluate patients with stage I-III CRC from 2010-2015. The TD group was defined by the presence of TD on histopathology whereas the HR group was defined by the presence of obstruction, perforation or T4 stage.

Results:

A total of 151 patients with CRC were identified, of which 50 had TD and 101 had a HR feature. The overall risk of peritoneal recurrence was higher in the TD group vs HR group (36.0 vs 19.8%, p=0.03). The risk of peritoneum as the site of first recurrence was also higher in the TD group (22.0 vs 12.9%, p=0.03). Overall cancer recurrence at any site was also higher in the TD group (56.0 vs 34.7%, p=0.01). Median time to first recurrence was 1.2 (0.7-1.9) years in the TD group compared to 1.4 (0.8-2.1) years in the HR group (p=0.31). Cancer-specific mortality was found to be 24.0% in the TD versus 15.8% in the HR group (p=0.22) with a median survival of 7.6 and 10.1 years in the TD and HR groups, respectively (p=0.03). The median overall recurrence free survival was noted to be 1.5 years in the TD group compared to 5.7 years in the HR group (p < 0.001).

Conclusions:

In non-metastatic CRC patients, those with TD have a higher risk of both overall and peritoneal recurrence compared to their high-risk counterparts. Alternative strategies for surveillance and treatment should be considered.

Learning Objectives:

Upon completion, participant will be able to establish that tumor deposits are comparable in prognosis with other known high risk features in patients with colorectal cancer.
Upon completion, participant will be able to appraise that tumor deposits increase the risk of peritoneal recurrence in patients with colorectal cancer.
Upon completion, participant will be able to recognise that aggressive systemic therapy is needed to combat high failure rate in patients with tumor deposits.