ArticleBMC cancer2023
Interaction analysis of high-risk pathological features on adjuvant chemotherapy survival benefit in stage II colon cancer patients: a multi-center, retrospective study.
Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03794193 (The Effect of Unfavorable Histological Features on the Oncological Outcomes of Colon Cancer), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Unfavorable Histological Features on the Oncological Outcomes of Colon Cancer
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- Efficacy and safety of 3-month versus 6-month oxaliplatin-based adjuvant chemotherapy in colorectal cancer: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Emergency Surgery Independently Predicts Postoperative Recurrence in Patients with Pathologic T3N0M0 Colon Cancer: A Retrospective Single-Center Cohort Study.Current oncology (Toronto, Ont.) · 2026Article
- Disease Stage-Dependent Clinical Impact ofCancers · 2026Article
- Perineural Invasion Worsens Long-Term Outcomes of Pancreatic Neuroendocrine Tumors Following Surgical Resection.Annals of surgical oncology · 2026Article
- Integrating lymphovascular and perineural invasion into TNM staging: a novel ITNM system for enhanced prognostic stratification in colorectal cancer.Frontiers in oncology · 2026Article
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Authors and funding
23 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundWe aimed to analyze the benefit of adjuvant chemotherapy in high-risk stage II colon cancer patients and the impact of high-risk factors on the prognostic effect of adjuvant chemotherapy.
methodsThis study is a multi-center, retrospective study, A total of 931 patients with stage II colon cancer who underwent curative surgery in 8 tertiary hospitals in China between 2016 and 2017 were enrolled in the study. Cox proportional hazard model was used to assess the risk factors of disease-free survival (DFS) and overall survival (OS) and to test the multiplicative interaction of pathological factors and adjuvant chemotherapy (ACT). The additive interaction was presented using the relative excess risk due to interaction (RERI). The Subpopulation Treatment Effect Pattern Plot (STEPP) was utilized to assess the interaction of continuous variables on the ACT effect.
resultsA total of 931 stage II colon cancer patients were enrolled in this study, the median age was 63 years old (interquartile range: 54-72 years) and 565 (60.7%) patients were male. Younger patients (median age, 58 years vs 65 years; P < 0.001) and patients with the following high-risk features, such as T4 tumors (30.8% vs 7.8%; P < 0.001), grade 3 lesions (36.0% vs 22.7%; P < 0.001), lymphovascular invasion (22.1% vs 6.8%; P < 0.001) and perineural invasion (19.4% vs 13.6%; P = 0.031) were more likely to receive ACT. Patients with perineural invasion showed a worse OS and marginally worse DFS (hazardous ratio [HR] 2.166, 95% confidence interval [CI] 1.282-3.660, P = 0.004; HR 1.583, 95% CI 0.985-2.545, P = 0.058, respectively). Computing the interaction on a multiplicative and additive scale revealed that there was a significant interaction between PNI and ACT in terms of DFS (HR for multiplicative interaction 0.196, p = 0.038; RERI, -1.996; 95%CI, -3.600 to -0.392) and OS (HR for multiplicative interaction 0.112, p = 0.042; RERI, -2.842; 95%CI, -4.959 to -0.725).
conclusionsPerineural invasion had prognostic value, and it could also influence the effect of ACT after curative surgery. However, other high-risk features showed no implication of efficacy for ACT in our study.
trial registrationThis study is registered on ClinicalTrials.gov, NCT03794193 (04/01/2019).
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