Survival paradox and effect of adjuvant chemotherapy for high-risk Stage II and low-risk Stage III colorectal cancer
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View abstract on PubMed
Summary
This summary is machine-generated.High-risk Stage II colorectal cancer shows a worse prognosis than low-risk Stage III. Adjuvant chemotherapy improved survival in some Stage III groups but not high-risk Stage II (T4N0) colorectal cancer.
Area Of Science
- Oncology
- Gastroenterology
- Surgical Oncology
Background
- Colorectal cancer staging (Stage II vs. Stage III) impacts prognosis.
- High-risk Stage II colorectal cancer may present a worse prognosis than low-risk Stage III.
- Limited data exists on adjuvant chemotherapy efficacy in specific Stage II and III subgroups.
Purpose Of The Study
- To compare the prognosis of high-risk Stage II (T4N0) and low-risk Stage III colorectal cancer.
- To evaluate the efficacy of adjuvant chemotherapy in these subgroups.
Main Methods
- Retrospective review of 598 patients with laparoscopic colorectal resection.
- Inclusion criteria: high-risk Stage II (T4N0) or low-risk Stage III (T1-2N1, T1-2N2, T3N1) colorectal cancer.
- Data collected between April 2016 and December 2022 from a multicenter database.
Main Results
- Fewer T4N0 patients received adjuvant chemotherapy compared to Stage III groups (p < 0.001).
- T4N0 group exhibited significantly worse 5-year relapse-free survival (RFS) than the T1-2N1 group (67.0% vs. 95.5%, p < 0.01).
- Adjuvant chemotherapy improved 5-year overall survival (OS) in T1-2N1 and T3N1 groups, but not in the T4N0 group.
Conclusions
- High-risk Stage II (T4N0) colorectal cancer may have a poorer prognosis than low-risk Stage III.
- Adjuvant chemotherapy benefits were observed in certain Stage III subgroups but not in T4N0.
- Consideration of preoperative treatment for T4N0 colorectal cancer is suggested.
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