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Purpose <p>High-risk Stage II may have a worse prognosis than low-risk Stage III colorectal cancer and there are limited reports examining the efficacy of adjuvant chemotherapy in Stage II and III subgroups.</p> Methods <p>Using a multicenter database, 598 colorectal cancer patients who underwent laparoscopic colorectal resection and were pathologically diagnosed with high-risk Stage II (T4N0) or low-risk Stage III (T1-2N1, T1-2N2, T3N1) between April 2016 and December 2022 were retrospectively reviewed.</p> Results <p>Fewer patients received adjuvant chemotherapy in the T4N0 group (54.7/45.0/44.7/27.7%, p &lt; 0.001). The T4N0 group had significantly worse 5-year relapse-free survival (RFS) (67.0 vs. 95.5%, p &lt; 0.01) and than the T1-2N1 group. The T4N0 group had significantly worse 5-year RFS (67.0% vs. 95.5%, p &lt; 0.01) than the T1-2N1 group. Five-year OS was significantly better in the T1-2N1 and T3N1 groups with than without adjuvant chemotherapy (p &lt; 0.032, p &lt; 0.001, respectively), but not in the T4N0 group.</p> Conclusions <p>The present multicenter study showed that high-risk Stage II colorectal cancer may have a worse prognosis than low-risk Stage III colorectal cancer. Preoperative treatment may be considered for T4N0 colorectal cancer.</p>

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Survival paradox and effect of adjuvant chemotherapy for high-risk Stage II and low-risk Stage III colorectal cancer

  • 期刊论文

  • 发表日期：

    2025年3月21日

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  • Keisuke Noda,
  • Tetsuro Tominaga,
  • Takashi Nonaka,
  • Rika Ono,
  • Kaido Oishi,
  • Yuma Takamura,
  • Toshio Shiraishi,
  • Shintaro Hashimoto,
  • Makoto Hisanaga,
  • Hiroaki Takeshita,
  • Mitsutoshi Ishii,
  • Shosaburo Oyama,
  • Kazuhide Ishimaru,
  • Terumitsu Sawai,
  • Keitaro Matsumoto

摘要

Purpose

High-risk Stage II may have a worse prognosis than low-risk Stage III colorectal cancer and there are limited reports examining the efficacy of adjuvant chemotherapy in Stage II and III subgroups.

Methods

Using a multicenter database, 598 colorectal cancer patients who underwent laparoscopic colorectal resection and were pathologically diagnosed with high-risk Stage II (T4N0) or low-risk Stage III (T1-2N1, T1-2N2, T3N1) between April 2016 and December 2022 were retrospectively reviewed.

Results

Fewer patients received adjuvant chemotherapy in the T4N0 group (54.7/45.0/44.7/27.7%, p < 0.001). The T4N0 group had significantly worse 5-year relapse-free survival (RFS) (67.0 vs. 95.5%, p < 0.01) and than the T1-2N1 group. The T4N0 group had significantly worse 5-year RFS (67.0% vs. 95.5%, p < 0.01) than the T1-2N1 group. Five-year OS was significantly better in the T1-2N1 and T3N1 groups with than without adjuvant chemotherapy (p < 0.032, p < 0.001, respectively), but not in the T4N0 group.

Conclusions

The present multicenter study showed that high-risk Stage II colorectal cancer may have a worse prognosis than low-risk Stage III colorectal cancer. Preoperative treatment may be considered for T4N0 colorectal cancer.