Objective  To evaluate the prognostic impact of tumor deposits on the overall survival (OS) of gastric cancer (GC) patients.

  Methods  Between January 2007 and December 2012, 312 GC patients undergoing curative resection in The First Affiliated Hospital of Hainan Medical University were enrolled. Patients were categorized into two groups based on the tumor deposit status of postoperative pathology:positive group, presence of tumor deposits and negative group, absence of tumor deposits. The correlations of tumor deposit status with clinicopathological and potential prognostic factors were analyzed.

  Results  Eighty-four (26.9%) patients had tumor deposits. There were significant differences in Borrmann type, tumor size, depth of invasion, N stage, tumor-node-metastasis (TNM) stage, and lymphovascular invasion between the two groups on univariate analysis. Multivariate analysis revealed that Borrmann type, N stage, and lymphovascular invasion were independently associated with the presence of tumor deposits. In univariate survival analysis, age, tumor location, Borrmann type, tumor size, TNM stage, type of gastrectomy, lymphovascular invasion, and presence of tumor deposits were found to be significant prognostic factors. GC patients with tumor deposits had a significantly lower 5-year OS rate than those without tumor deposits (5-year OS:34.5% vs. 67.5%, P < 0.001). Multivariate analysis revealed that age, Borrmann type Ⅲ/Ⅳ, TNM stage, lymphovascular invasion, and presence of tumor deposits were independent prognostic factors for this cohort. Further stratified analysis demonstrated that the significant prognostic differences between the two groups were only observed in patients with stage N0-3a disease. There were no significant differences in survival between patients with and without tumor deposits at the N3b stage. The prognosis of GC patients with tumor deposits was independently correlated with N stage, lymphovascular invasion, and postoperative chemotherapy.

  Conclusions  The presence of tumor deposits was an independent prognostic factor in GC patients and can be used as a prognostic indicator for GC patients with stage N0-3a disease. GC patients with tumor deposits should receive postoperative chemotherapy regardless of TNM stage.