Tumor deposits in the impact of esophageal squamous cell carcinoma prognosis and recurrence: A multicenter retrospective cohort study

Purposes: Tumor deposits (TDs) are considered poor prognostic factors in esophageal squamous cell carcinoma (ESCC). However, the impact of tumor deposits-positivity (TDP) on ESCC prognosis and recurrence remains unclear. This multicenter retrospective cohort study aimed to investigate the influence of TDP on recurrence and the potential benefit of adjuvant therapy in ESCC. Methods: Data were collected from four large-scale hospitals on ESCC patients who underwent R0 esophagectomy for stage T1-4N0-3M0 from January 2008 to January 2019. The clinicopathological features, prognosis, and risk factors for TDP were evaluated. Subgroup analyses were conducted based on adjuvant chemotherapy status and recurrence patterns. Results: A total of 2244 patients were enrolled in our study. 688 patients were analyzed after propensity score matching. Patients who were categorized as T1-4N0M0 with TDP status had a similar prognosis to T1-4N1M0 (P = 0.95) or T1-4N2M0 (P = 0.42) with tumor deposits-negativity (TDN) status. In the T1-4N0M0 and T1-4N1M0 stage groups, the 5-year RFS rate and 5-year OS in the TDP group differed significantly from the TDN group (P < 0.001). Among T1-4N0M0 with adjuvant chemotherapy patients, TDP patients had significantly worse OS compared to TDN patients (P < 0.001). Furthermore, TDP patients exhibited a higher cumulative incidence for local recurrence (P < 0.001) and distant recurrence rate (P < 0.001). Conclusions: TDP is a risk factor for recurrence in ESCC and plays a significant role in the discussion of ESCC treatment strategies. TDP patients may benefit from adjuvant chemotherapy, emphasizing the importance of monitoring these patients during follow-up.