A comprehensive overview of tumour deposits in colorectal cancer: Towards a next TNM classification

• Published in: Cancer treatment reviews 2022-02, Vol.103, p.102325-102325, Article 102325
• Main Authors: Delattre, Jean-François, Selcen Oguz Erdogan, Ayse, Cohen, Romain, Shi, Qian, Emile, Jean-François, Taieb, Julien, Tabernero, Josep, André, Thierry, Meyerhardt, Jeffrey A., Nagtegaal, Iris D., Svrcek, Magali
• Format: Article
• Language: English
• Subjects: Colorectal cancer; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Extra-mural vascular invasion; Histoprognostic factor; Humans; Life Sciences; Lymph node metastasis; Lymph Nodes - pathology; Lymphatic Metastasis - pathology; Neoplasm Staging - methods; Perineural invasion; Prognosis; TNM classification; Tumour deposit
• ISSN: 0305-7372; 1532-1967
• DOI: 10.1016/j.ctrv.2021.102325

•Tumour deposits (TDs) appear in ∼ 20% of colorectal cancer; linked to poor prognosis.•Often ignored in pathology reports in large locoregional colorectal cancer series.•TDs are currently underestimated in TNM staging and by non-pathologist specialists.•If lymph node metastasis are present, TDs have no impact on tumor staging.•TDs are important in light of personalized adjuvant therapy in stage III CC. The management of colorectal cancer (CRC) highly relies on the TNM staging system. Tumour deposits (TDs), important histoprognostic factors, are detected in approximately 20% of CRCs and associated with poor prognosis. Integration of TDs in the TNM staging remains a subject of lively debate and differs over the successive TNM classifications. Currently TDs, whatever their number, are considered in pathologic staging only in the absence of lymph node metastasis (LNM; subcategory pN1c). However, the medical community is divided over this way of integrating TDs in the TNM staging system. Considering the personalization of the type and duration of adjuvant chemotherapy in stage III colon cancer according to the number of LNM, this issue has become of growing importance. Thus, ignoring TDs in the presence of LNM represents a major prognostic underestimation and leads to wrong therapeutic decisions. Hence, considering the growing significance of prognostic role, the scientific complexity, and a potential therapeutic effect of TDs, we provide an overview of current knowledge about TDs. Based on the results from recent publications, we also provide plausible scenarios of integration of TDs into the next TNM classification system.