{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:16:13Z","timestamp":1790802973152,"version":"4.1.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002794","name":"Swedish Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tumour deposits are a prognostic factor for overall survival and distant metastasis in lymph node-negative colorectal cancer. However, the current TNM staging system does not account for the presence of tumour deposits in lymph node-positive colorectal cancer, or for the presence of multiple deposits. This study aimed to investigate the prognostic effect of tumour deposit count in patients with colorectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent curative surgery for colorectal cancer between 2016 and 2019 were identified nationwide from the Swedish Colorectal Cancer Registry. Patients with undisclosed tumour deposit status\/count and stage IV disease were excluded. Univariable and multivariable Cox regression analyses were used to assess the prognostic effect of tumour deposit count on overall survival and distant metastasis adjusted for age, sex, neoadjuvant treatment, and number of positive lymph nodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 18 913 patients assessed, 14 154 patients were analysed with tumour deposits (TDs) present in 1702 (12%) patients. Patients were stratified by tumour deposit count (0, 1, 2, 3, 4, and \u22655 TDs). Increased tumour deposit count was associated with decreased 5-year overall survival (79%, 70%, 61%, 66%, 50%, 49%) and increased 5-year risk for distant metastasis (14%, 26%, 35%, 41%, 48%, 54%) respectively. Tumour deposit count remained an independent negative prognostic factor after multivariable Cox regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tumour deposit count is a negative prognostic predictor of both overall survival and distant metastasis in colorectal cancer, independent of positive lymph nodes or neoadjuvant treatment. These findings suggest that tumour deposit count should be integrated into the TNM staging regardless of lymph nodes status to improve prognostic accuracy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znae309","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T23:27:48Z","timestamp":1733182068000},"source":"Crossref","is-referenced-by-count":18,"title":["Tumour deposit count is an independent prognostic factor in colorectal cancer\u2014a population-based cohort study"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5602-7128","authenticated-orcid":false,"given":"Simon","family":"Lundstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Surgery, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]},{"name":"Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4463-2336","authenticated-orcid":false,"given":"Erik","family":"Agger","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]},{"name":"Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4803-8548","authenticated-orcid":false,"given":"Marie-Louise","family":"Lydrup","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]},{"name":"Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3876-4033","authenticated-orcid":false,"given":"Fredrik","family":"J\u00f6rgren","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]},{"name":"Department of Surgery, Helsingborg Hospital, Lund University , Helsingborg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6407-5552","authenticated-orcid":false,"given":"Pamela","family":"Buchwald","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]},{"name":"Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"2025062421154909900_znae309-B1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1136\/gutjnl-2022-327736","article-title":"Global burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN","volume":"72","author":"Eileen","year":"2023","journal-title":"Gut"},{"key":"2025062421154909900_znae309-B2","volume-title":"TNM Classification of Malignant Tumours","author":"Brierley J","year":"2017","edition":"8th edn"},{"key":"2025062421154909900_znae309-B3","first-page":"175","article-title":"Global pattern and trends of colorectal cancer survival: a systematic review of population-based registration data","volume":"19","author":"Jiang","year":"2021","journal-title":"Cancer Biol Med"},{"key":"2025062421154909900_znae309-B4","doi-asserted-by":"crossref","first-page":"e000644","DOI":"10.1136\/bmjgast-2021-000644","article-title":"Survival in colon and rectal cancers in Finland and Sweden through 50 years","volume":"8","author":"Hemminki","year":"2021","journal-title":"BMJ Open Gastroenterol"},{"key":"2025062421154909900_znae309-B5","volume-title":"TNM Classification of Malignant Tumours","author":"Sobin","year":"2009","edition":"7th edn"},{"key":"2025062421154909900_znae309-B6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/ags3.12652","article-title":"Tumor deposits in colorectal cancer: refining their definition in the TNM system","volume":"7","author":"Ueno","year":"2023","journal-title":"Ann Gastroenterol Surg"},{"key":"2025062421154909900_znae309-B7","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1200\/JCO.2016.68.9091","article-title":"Tumor deposits in colorectal cancer: improving the value of modern staging\u2014a systematic review and meta-analysis","volume":"35","author":"Nagtegaal","year":"2017","journal-title":"J Clin Oncol"},{"key":"2025062421154909900_znae309-B8","doi-asserted-by":"crossref","first-page":"zrad122","DOI":"10.1093\/bjsopen\/zrad122","article-title":"Tumour deposits in colon cancer predict recurrence and reduced survival in a nationwide population-based study","volume":"7","author":"J\u00f6rgren","year":"2023","journal-title":"BJS Open"},{"key":"2025062421154909900_znae309-B9","doi-asserted-by":"crossref","first-page":"e526","DOI":"10.1097\/SLA.0000000000005755","article-title":"Negative prognostic impact of tumor deposits in rectal cancer\u2014a national study cohort","volume":"278","author":"Agger","year":"2022","journal-title":"Ann Surg"},{"key":"2025062421154909900_znae309-B10","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s00384-023-04365-1","article-title":"Adverse impact of tumor deposits in lymph node negative rectal cancer\u2014a national cohort study","volume":"38","author":"Lundstr\u00f6m","year":"2023","journal-title":"Int J Colorectal Dis"},{"key":"2025062421154909900_znae309-B11","doi-asserted-by":"crossref","first-page":"5570","DOI":"10.1245\/s10434-024-15552-x","article-title":"Risk factors for recurrence after surgery for rectal cancer in a modern, nationwide population-based cohort","volume":"31","author":"Doroudian","year":"2024","journal-title":"Ann Surg Oncol"},{"key":"2025062421154909900_znae309-B12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/j.1365-2559.2007.02720.x","article-title":"Colorectal tumour deposits in the mesorectum and pericolon; a critical review","volume":"51","author":"Nagtegaal","year":"2007","journal-title":"Histopathology"},{"key":"2025062421154909900_znae309-B13","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1002\/cncr.26310","article-title":"Intramural and extramural vascular invasion in colorectal cancer","volume":"118","author":"Betge","year":"2012","journal-title":"Cancer"},{"key":"2025062421154909900_znae309-B14","doi-asserted-by":"crossref","first-page":"733","DOI":"10.21037\/atm.2020.03.175","article-title":"Tumor deposits in colorectal cancer: the need for a new \u201cpN\u201d category","volume":"8","author":"Lino-Silva","year":"2020","journal-title":"Ann Transl Med"},{"key":"2025062421154909900_znae309-B15","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12957-022-02501-9","article-title":"The value of tumor deposits in evaluating colorectal cancer survival and metastasis: a population-based retrospective cohort study","volume":"20","author":"Wu","year":"2022","journal-title":"World J Surg Oncol"},{"key":"2025062421154909900_znae309-B16","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1080\/0284186X.2018.1529425","article-title":"Evaluation of the Swedish Colorectal Cancer Registry: an overview of completeness, timeliness, comparability and validity","volume":"57","author":"Moberger","year":"2018","journal-title":"Acta Oncologica"},{"key":"2025062421154909900_znae309-B17","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1080\/0284186X.2021.1896033","article-title":"Completeness and accuracy of the registration of recurrences in the Swedish Colorectal Cancer Registry (SCRCR) and an update of recurrence risk in colon cancer","volume":"60","author":"Osterman","year":"2021","journal-title":"Acta Oncologica"},{"key":"2025062421154909900_znae309-B18","volume-title":"R Core: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2023"},{"key":"2025062421154909900_znae309-B19","volume-title":"RStudio: Integrated Development for R","author":"RStudio Team","year":"2020"},{"key":"2025062421154909900_znae309-B20","volume-title":"A Package for Survival Analysis in R","author":"Therneau","year":"2022"},{"key":"2025062421154909900_znae309-B21","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-24277-4","volume-title":"ggplot2: Elegant Graphics for Data Analysis","author":"Wickham","year":"2016"},{"key":"2025062421154909900_znae309-B22","first-page":"1","article-title":"mice: multivariate imputation by chained equations in R","volume":"45","author":"van Buuren","year":"2011","journal-title":"J Stat Softw"},{"key":"2025062421154909900_znae309-B23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v087.i08","article-title":"Nonparametric relative survival analysis with the R package relsurv","volume":"87","author":"Perme","year":"2018","journal-title":"J Stat Softw"},{"key":"2025062421154909900_znae309-B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejca.2019.12.025","article-title":"Pathways of spread in rectal cancer: a reappraisal of the true routes to distant metastatic disease","volume":"128","author":"Lord","year":"2020","journal-title":"Eur J Cancer"},{"key":"2025062421154909900_znae309-B25","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1002\/cac2.12598","article-title":"Unraveling the routes to distant metastases in colorectal cancer: tumor deposits and lymph node metastases as the gateway","volume":"44","author":"Brouwer","year":"2024","journal-title":"Cancer Communications"},{"key":"2025062421154909900_znae309-B26","doi-asserted-by":"crossref","first-page":"5791","DOI":"10.3390\/cancers15245791","article-title":"Recurrence patterns and risk factors after curative resection for colorectal cancer: insights for postoperative surveillance strategies","volume":"15","author":"Ryu","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2025062421154909900_znae309-B27","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.ctrv.2015.06.007","article-title":"Rectal and colon cancer: not just a different anatomic site","volume":"41","author":"Tamas","year":"2015","journal-title":"Cancer Treat Rev"},{"key":"2025062421154909900_znae309-B28","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1080\/08941939.2022.2069306","article-title":"Prognostic value of tumor deposit counts in patients with stage III colorectal cancer: a population-based study","volume":"35","author":"Long","year":"2022","journal-title":"J Invest Surg"},{"key":"2025062421154909900_znae309-B29","doi-asserted-by":"crossref","first-page":"102325","DOI":"10.1016\/j.ctrv.2021.102325","article-title":"A comprehensive overview of tumour deposits in colorectal cancer: towards a next TNM classification","volume":"103","author":"Delattre","year":"2022","journal-title":"Cancer Treat Rev"},{"key":"2025062421154909900_znae309-B30","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00384-021-04036-z","article-title":"Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis","volume":"37","author":"Moon","year":"2022","journal-title":"Int J Colorectal Dis"},{"key":"2025062421154909900_znae309-B31","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/COC.0000000000000645","article-title":"Tumor deposits in stage III colon cancer: correlation with other histopathologic variables, prognostic value, and risk stratification-time to consider \u201cN2c\u201d","volume":"43","author":"Pricolo","year":"2020","journal-title":"Am J Clin Oncol"},{"key":"2025062421154909900_znae309-B32","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.4251\/wjgo.v14.i9.1699","article-title":"Prognostic impact of tumor deposits on overall survival in colorectal cancer: based on surveillance, epidemiology, and end results database","volume":"14","author":"Wu","year":"2022","journal-title":"World J Gastrointest Oncol"},{"key":"2025062421154909900_znae309-B33","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1038\/s41598-019-57041-2","article-title":"Reconsidering the prognostic significance of tumour deposit count in the TNM staging system for colorectal cancer","volume":"10","author":"Wang","year":"2020","journal-title":"Sci Rep"},{"key":"2025062421154909900_znae309-B34","doi-asserted-by":"crossref","first-page":"571154","DOI":"10.3389\/fmed.2020.571154","article-title":"A modified tumor-node-metastasis classification for stage III colorectal cancers based on treating tumor deposits as positive lymph nodes","volume":"7","author":"Pei","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"2025062421154909900_znae309-B35","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.pathol.2022.07.014","article-title":"What are the problems with the current staging of discontinuous tumour nodules (DTNs) in colorectal carcinoma? Is there a better way?","volume":"54","author":"Karbanowicz","year":"2022","journal-title":"Pathology"},{"key":"2025062421154909900_znae309-B36","doi-asserted-by":"crossref","first-page":"548692","DOI":"10.3389\/fonc.2020.548692","article-title":"A modified pathological N stage including status of tumor deposits in colorectal cancer with nodal metastasis","volume":"10","author":"Pei","year":"2020","journal-title":"Front Oncol"},{"key":"2025062421154909900_znae309-B37","doi-asserted-by":"crossref","first-page":"769","DOI":"10.21037\/atm.2019.11.69","article-title":"The unique prognostic characteristics of tumor deposits in colorectal cancer patients","volume":"7","author":"Liu","year":"2019","journal-title":"Ann Transl Med"},{"key":"2025062421154909900_znae309-B38","doi-asserted-by":"crossref","first-page":"e1916987","DOI":"10.1001\/jamanetworkopen.2019.16987","article-title":"Assessment of a staging system for sigmoid colon cancer based on tumor deposits and extramural venous invasion on computed tomography","volume":"2","author":"D'Souza","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2025062421154909900_znae309-B39","doi-asserted-by":"crossref","first-page":"e033395","DOI":"10.1136\/bmjopen-2019-033395","article-title":"Can extranodal tumour deposits be diagnosed on MRI? Protocol for a multicentre clinical trial (the COMET trial)","volume":"10","author":"Lord","year":"2020","journal-title":"BMJ Open"},{"key":"2025062421154909900_znae309-B40","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1097\/SLA.0000000000004499","article-title":"MRI-diagnosed tumor deposits and EMVI status have superior prognostic accuracy to current clinical TNM staging in rectal cancer","volume":"276","author":"Lord","year":"2022","journal-title":"Ann Surg"},{"key":"2025062421154909900_znae309-B41","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/his.14344","article-title":"Histopathological diagnosis of tumour deposits in colorectal cancer: a Delphi consensus study","volume":"79","author":"Lord","year":"2021","journal-title":"Histopathology"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/112\/1\/znae309\/61295040\/znae309.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/112\/1\/znae309\/61295040\/znae309.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T21:16:01Z","timestamp":1750799761000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/doi\/10.1093\/bjs\/znae309\/7934694"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12,30]]},"published-print":{"date-parts":[[2024,12,24]]}},"URL":"https:\/\/doi.org\/10.1093\/bjs\/znae309","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,12,24]]},"article-number":"znae309"}}