الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
this study show that tumor deposit is an independent prognostic factor in colorectal carcinoma patients that affect negatively both OS and DFS with significant association between it and LVI, PNI, LN metastasis, tumor invasion. Also presence of both TDs and LN metastases confers additive risk. Presence of both elements was, in fact, associated with significantly worse survival than each of these risk factors alone. In addition patients who received neoadjuvant chemotherapy and\or radiotherapy are more likely to be tumor deposit negative and lymph node negative with better OS. All these preliminary data in this study required more in depth studying such as performing the study on a larger sample size of cases with different colorectal carcinoma types and grades to improve the statistical power and reduce the statistical bias. Also we recommend further molecular studies to better understand tumor deposits pathogenesis and if they are sharing the same pathogenesis as lymph node metastasis. There is necessity for changing TNM staging according to large number of studies formed on TDs which proved that TDs is an independent prognostic factor. They can add number of TDs to number of LNM or by adding separate entity for TDs. Further studies needed with larger sample size on patients who received neoadjuvant chemotherapy and its relation to tumor deposits and prognosis. Colorectal carcinoma (CRC), the most commonly diagnosed gastrointestinal malignant tumor and the second leading cause of cancer-related deaths worldwide, is a heavy health burden nowadays. Several studies have been applied to predict prognostic factors for colorectal carcinoma. The main aim of these studies was to improve patient’s overall survival and maintains their physical and social activity in a perfect manner. Several factors were found to be involved in prediction of the overall survival of colorectal carcinoma patients, one of the important prognostic factors was tumor deposit. Tumor deposit was defined as a discrete nodule of cancer in pericolic/perirectal fat or adjacent mesentery, without histological evidence of residual lymph node or identifiable vascular or neural structures. One hundred and thirty three cases with stage I–IV CRC who underwent primary tumor resection for operable cases in the period between January 2017 and December 2019 and followed up until June 2022 were included in this study. Cases were selected from the registry of Pathology Department at South Egypt Cancer Institute (SECI). The H &E stained slides of these cases were examined initially and the tumors were staged according to AJCC TNM classification eighth edition. Pathological and clinical data were collected and recorded. Our current study shows that the tumor deposit is an independent factor to determine the overall survival or to predict the outcome and prognosis of colorectal carcinoma patient with significant association between TDs and level of tumor invasion, PNI and LN metastasis. According to grouping of our study submitted patients, 3-year survival rates were nearly similar for LN−ve TD−ve, LN+ve TD−ve, but significantly worse for LN−ve TD+ve, LN+ve TD+ve (P<0.001), this maens that presence of both TDs and LN metastases confers additive risk. Presence of both elements was, in fact, associated with significantly worse survival than each of these risk factors alone. The presence of LN+ve TD+ve was more often associated with advanced tumor invasion, LN metastasis, PNI+ve, and LVI+ve, than LN+ve TD−ve or LN−ve TD+ve or LN-ve TD-ve. As we study the relation between the submitted groups and neoadjuvant therapy, there was a significant relation as follow patients who received neoadjuvant therapy were negative for tumor deposit and lymph nodes, while patients not received neoadjuvant therapy were positive tumor deposit and positive lymph node (P=0.014).