ArticleJournal of gastrointestinal cancer2025
Adjuvant Chemotherapy for High-Risk Stage II Colon Cancer: A Population-Based Study.
Article in Journal of gastrointestinal cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundAdjuvant chemotherapy is recommended as an option for patients who have high-risk features. It remains unclear whether all patients with high-risk stage II colon cancer benefit from adjuvant therapy. The primary aim of this study is to evaluate the association between adjuvant chemotherapy and overall survival in patients with high-risk stage II colon cancer.
methodsUtilizing the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2019, adult patients with high-risk stage II colon cancer defined as T4 tumor classification, perineural invasion, less than 12 lymph nodes harvested, and poorly differentiated histology. 1:1 ratio propensity matching was used to adjust for confounding variables. Survival differences based on receipt of adjuvant systemic therapy were summarized using a log rank test. Cox proportion hazard regression was used to evaluate overall survival.
resultsOf the 11,619 patients who met inclusion criteria, 2775 (24%) received adjuvant chemotherapy. Patients were more likely to receive adjuvant therapy if they were younger, married or partnered, or had left-sided lesions. Kaplan-Meier estimates showed an improvement in overall survival (log-rank test < 0.001). On pair-stratified Cox proportional hazards regression, adjuvant chemotherapy receipt was associated with 30% lower mortality hazard (hazard ratio [HR] 0.70; 95% CI 0.62, 0.80; p < 0.001). However, on landmark analysis, after excluding patients surviving < 3 months, adjuvant chemotherapy was no longer associated with mortality hazard (HR 0.90; 95% CI 0.79, 1.04; p = 0.144).
conclusionThe findings from this large SEER database study provide support for not undergoing adjuvant chemotherapy to patients with high-risk stage II colon cancer.
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