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Meta-Analysis
. 2019 May;74(6):809-816.
doi: 10.1111/his.13781. Epub 2019 Feb 10.

Tumour deposits are a significant prognostic factor in gastric cancer - a systematic review and meta-analysis

Cristina Graham Martínez  1 , Nikki Knijn  1 , Marcel Verheij  2 , Iris D Nagtegaal  1 , Rachel S van der Post  1
Affiliations
Meta-Analysis

Tumour deposits are a significant prognostic factor in gastric cancer - a systematic review and meta-analysis

Cristina Graham Martínez et al. Histopathology. 2019 May.

Abstract

Aims: Tumour deposits (TDs) are clusters of cancer cells in the soft tissue that are discontinuous from the primary tumour. In this review we are exploring their relevance for prognosis in patients with gastric cancer.

Methods and results: A literature search was performed to identify studies providing data on TDs and prognosis in gastric cancer patients. Eight papers were included in the meta-analysis, which was carried out in terms of risk ratios (RR) and hazard ratios (HR) with 95% confidence interval (95% CI). Of 7445 patients, 1551 had TDs (20.9%). TDs were associated with a decreased overall survival (OS) in univariate (HR = 2.82, 95% CI = 1.9-4.3) and multivariate analyses (HR = 1.65, 95% CI = 1.3-2.1). TDs were also associated with known prognostic factors such as synchronous metastatic disease (RR = 9.5), invasion depth (RR = 1.8), lymph node metastasis (RR = 1.7), lymphatic invasion (RR = 1.7), vascular invasion (RR = 2.6) and poor differentiation (RR = 1.2).

Conclusions: We found a strong indication that TDs are independent predictors of prognosis in patients with gastric cancer; hence, TDs should be included in the staging of gastric cancers.

Keywords: gastric neoplasms; prognosis; staging; tumour deposits.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart showing the article search strategy for the systematic review.The steps followed were identification of papers in the search, selection with eligibility criteria and final inclusion of papers. TDs, tumour deposits; CRT, chemoradiotherapy; RT, radiotherapy; GC, gastric cancer [Colour figure can be viewed at wileyonlinelibrary.com].
Figure 2
Figure 2
The impact of TDs on patient outcome, measured by overall survival with a univariate analysis (A) and multivariate analysis (B). SE, standard error; TDs, tumour deposits; CI, confidence interval; IV, inverse variance.
Figure 3
Figure 3
Association between TDs and histological risk factors. A, Correlation between TDs and higher tumour categories (T1/T2 versus T3/T4). B, Correlation between TDs and LNM. C, Correlation between TDs and LVI. D, Correlation between TDs and VI. E, Correlation between TDs and metastasis (M1). TDs: tumour deposits; LNM, lymph node metastasis; LVI, lymph vessel invasion; VI, vascular invasion; M0, non‐metastatic; M1, metastatic.
See this image and copyright information in PMC

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