ArticleThe oncologist2026
Added value of adjuvant chemotherapy in patients with node-positive pT1-2 colon cancer: a national SNAPSHOT analysis.
Article in The oncologist, 2026. 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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Abstract
backgroundPatients with node-positive colon carcinoma commonly receive adjuvant chemotherapy, regardless the tumor's T-stage. However, early-stage tumors (pT1-2 CC) are largely underrepresented in landmark studies supporting this treatment. This study evaluates the application of adjuvant chemotherapy in those patients based on daily practice. PATIENTS AND
methodsPatients who underwent surgery for either pT1- or pT2-CC were identified from the nationwide SNAPSHOT database and stratified by age (<75 or ≥75 years). Competing risk regression and (cause-specific) Cox proportional hazard models identified factors associated with 5-year cumulative incidence of recurrence and overall survival (OS), respectively.
resultsLymph node metastases were found in 381 out of 2,312 (16.5%) patients, of whom 275 (72.2%) received adjuvant chemotherapy. The cumulative incidence of recurrence was 0.09 (95% CI 0.06-0.12) and 0.18 (95% CI 0.11-0.27) in patients who did or did not receive adjuvant chemotherapy, respectively (P = .007). In patients under 75, adjuvant chemotherapy was associated with significantly higher OS (91.3% vs 68.1%, P < .001). Corresponding OS probabilities in elderly patients (≥75 years) were 84.5% vs 55.1%, P = .003. After adjusting for confounding, this difference remained only significant in patients under 75: HRadj 0.5, 95% CI 0.1-0.7 and HRadj 0.5, 95% CI 0.2-1.3, respectively. The recurrence rate was not significantly different between patients receiving capecitabine/oxaliplatin (CapOx) and those on Capecitabine monotherapy (CIF 0.09, 95% CI 0.06-0.14 vs 0.05, 95% CI 0.01-0.16, P = .49).
conclusionAdjuvant chemotherapy is associated with reduced risk of recurrence in patients with node-positive pT1-2 CC. Advantages on OS could not be demonstrated in elderly pT1-2N1-2 patients.
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