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Background <p>Adjuvant 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.</p> Methods <p>Utilizing 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.</p> Results <p>Of 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 &lt; 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; <i>p</i> &lt; 0.001). However, on landmark analysis, after excluding patients surviving &lt; 3&#xa0;months, adjuvant chemotherapy was no longer associated with mortality hazard (HR 0.90; 95% CI 0.79, 1.04; <i>p</i> = 0.144).</p> Conclusion <p>The findings from this large SEER database study provide support for not undergoing adjuvant chemotherapy to patients with high-risk stage II colon cancer.</p>

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Adjuvant Chemotherapy for High-Risk Stage II Colon Cancer: A Population-Based Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月13日

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  • Annmarie Butare,
  • Tia Sutton,
  • Elizabeth Kantzler,
  • Katie N. Kennedy,
  • Dmitry Tumin,
  • Michael D. Honaker

摘要

Background

Adjuvant 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.

Methods

Utilizing 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.

Results

Of 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).

Conclusion

The findings from this large SEER database study provide support for not undergoing adjuvant chemotherapy to patients with high-risk stage II colon cancer.