Evaluation of the Role of Tumor Deposits on the Prognosis of Colorectal Carcinoma

Colorectal cancer remains the third most common cancer and the third leading cause of cancer-related deaths. For colon cancer alone, 101,220 new cases were projected to occur in 2019, causing51,020 deaths.

A number of risk factors have been identified that influence susceptibility to colorectal cancer, including a family history, the presence of adenomatous polyps, inflammatory bowel disease (ulcerative colitis or Crohn's disease), and number of environmental factors of which diet is the most significant.

CRC differs from many other cancers in that diagnosis of the disease can be made earlier by screening techniques including colonoscopy. The progression of CRC is well established and begins with hyperproliferation of the colonic mucosa and adenoma formation and then adenocarcinomas that vary in metastatic potential.

The progression from normal intestinal epithelium to an invasive carcinoma is estimated to take 7-12 years. With the advent of early screening measures developed over the last few decades, CRC has become a preventable disease by treating patients with adenomatous polyps. Nearly 50% of patients diagnosed with CRC develop metastasis within five years. Most commonly these tumors metastasize to the liver and lungs but may be discovered in many other sites.

Despite significant improvements in both prevention and screening over the last twenty years, about 36,500 (36%) of such cases are still being diagnosed in stage III, with regional lymph node involvement (LN+, N1a-b, N2a-b) or tumor deposits (TD+, N1c).