ArticleBMC cancer2026
Incorporating tumor deposits into the TNM staging of gastric cancer: a retrospective cohort study for prognostic validation and staging optimization.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTumor deposits (TD) have been identified as adverse prognostic indicators in gastric cancer (GC); however, their incorporation into the TNM staging system remains controversial. This study aimed to determine the most effective approach for integrating TD into the TNM staging system to improve prognostic accuracy.
methodsA retrospective analysis was performed on clinicopathological and follow-up data from patients who underwent radical surgery for gastric cancer (GC) at Yijishan Hospital, affiliated with Wannan Medical College, between January 2012 and December 2021. Patients were classified into TD-negative and TD-positive groups according to the presence or absence of TD in postoperative pathological reports.
resultsA total of 4,972 patients were analyzed, of whom 575 (11.56%) had TD. These patients were matched in a 1:1 ratio with 523 TD-negative patients. Several clinicopathological factors, including tumor size, T stage, N stage, neural invasion, and vascular invasion, were significantly associated with the presence of TD. Survival analysis revealed that patients with TD had significantly lower 5-year overall survival (OS) rates than those without TD across all TNM stage subgroups (I-II, IIIa, IIIb, and IIIc) (P < 0.05). The 5-year OS rates of patients with TD in stages I-II, IIIa, IIIb, and IIIc were comparable to those of TD-negative patients in stages IIIa, IIIc, IIIc, and IV, respectively (P > 0.05). The proposed staging system incorporating TD demonstrated the highest χ
conclusionTD represent independent prognostic factors in GC, distinct from the T, N, and M categories, and should be incorporated into the TNM staging system.
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