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ORIGINAL RESEARCH article

Front. Oncol.

Sec. Gastrointestinal Cancers: Colorectal Cancer

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1605030

This article is part of the Research TopicNational Colorectal Cancer Awareness Month 2025: Current Progress and Future Prospects on Colorectal Cancer Prevention, Diagnosis and TreatmentView all 10 articles

Utilizing tumor deposit count as a stratification criterion in revising TNM staging system for patients with colorectal cancer:a nomogram review study

Provisionally accepted
Li-Fei  ZhangLi-Fei Zhang1,2Yunna  MaYunna Ma2Jiantao  DongJiantao Dong1,2Jianhui  CaiJianhui Cai1,2*
  • 1Hebei Medical University, Shijiazhuang, Hebei Province, China
  • 2Hebei General Hospital, Shijiazhuang, China

The final, formatted version of the article will be published soon.

Background: TD is an independent risk factor associated with recurrence or metastasis for CRC patients . This study aimed to evaluate the prognostic impact of TD counts and revise TNM staging through utilizing TD count as a stratification criterion in CRC patients. Methods: Utilizing TD count as a stratification criterion, we regrouped the NM classification. Univariate and multivariate analysis were performed to identify significant factors. A nomogram was then created. The C-index, calibration plots and ROC were used to verify the model's accuracy. Results: Among the 60145 patients, 6092 (10.1%) had TDs, only 1384 (22.7%) staged as N1c. We introduced a novel stage, N2c, for patients with ten or more LNMs. The survival trajectories of CRC patients with more than 3 TDs were similar to those of patients in the N2c group and the M1a group. CRC patients with 3 or more TDs were finally assigned to the M1a. A nomogram was conducted. Both the training cohort and the validation group had an AUCs of about 0.8. Conclusions: Revised TNM staging predicts survival more accurately. CRC patients with more than 10 LNMs or 3 TDs have a level of malignancy comparable to the existence of distant metastases.

Keywords: colorectal cancer, tumor deposit, SEER, TNM, nomogram

Received: 02 Apr 2025; Accepted: 28 Jul 2025.

Copyright: © 2025 Zhang, Ma, Dong and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jianhui Cai, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China

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