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Background <p>Organ preservation is gaining attention, yet primary treatment approaches differ substantially between pT1 and pT2 colon cancer (CC). This study evaluates whether tumor invasion depth affects survival outcomes in patients with pT1-2N0-2 colon cancer.</p> Methods <p>In this nationwide cohort study, patients undergoing surgery for pT1 or pT2 CC between 2014 and 2015 were identified from the Dutch Snapshot Research Group’s SNAPSHOT complex colon cancer database. Five-year disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazard models.</p> Results <p>A total of 2312 patients were included (921 pT1 and 1391 pT2). Five-year DFS (83.5% vs. 83.2%, <i>P</i> = 0.79, adjusted HR [HR<sub>adj</sub>] pT2 vs. pT1: 0.9; 95% confidence interval [CI] 0.7–1.2) and 5-year OS (84.9% vs. 85.6%, <i>P</i> = 0.72, HR<sub>adj</sub> pT2 vs. pT1: 0.8; 95% CI 0.6–1.1) were comparable between pT1N0 and pT2N0 patients. Similarly, in pT1N+ and pT2N+ patients, there was no significant difference in DFS (81% vs. 75.8%, <i>P</i> = 0.31, HR<sub>adj</sub> pT2 vs. pT1: 1.3; 95% CI 0.6–2.6) or OS (84% vs. 82.5%, <i>P</i> = 0.73, HR<sub>adj</sub> pT2 vs. pT1: 0.9; 95% CI 0.5–1.6). Distant metastases developed in 37 (4%) pT1 patients and 68 (4.9%) pT2 patients (<i>P</i> = 0.33). Among these, 26 of 37 pT1 patients (70.3%) and 40 of 68 pT2 patients (58.8%) did not have lymph node metastases in the initial resection specimen (pN0).</p> Conclusions <p>Tumor invasion depth (pT1 or pT2) had no significant impact on DFS or OS following formal oncological resection. Furthermore, most distant metastases develop in pN0 patients, suggesting a minor influence of surgery on control of distant disease.</p>

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Depth of Tumor Invasion (T-Stage) is Not Associated with Survival or Recurrence Rates in Patients Undergoing Surgery for pT1 and pT2 Colon Cancer

  • 期刊论文

  • 发表日期：

    2025年12月24日

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  • Julia Hanevelt,
  • Eva Rademaker,
  • Bobby Zamaray,
  • Richard M. Brohet,
  • Leon M. G. Moons,
  • Frank P. Vleggaar,
  • Bart C. T. van de Laar,
  • Esther C. J. Consten,
  • Pieter J. Tanis,
  • Wouter H. de Vos tot Nederveen Cappel,
  • Henderik L. van Westreenen,
  • DC Aa,
  • SM Van Aalten,
  • I Aanen,
  • FJ Amelung,
  • P Van Amstel,
  • E Ancion,
  • JJ Atema,
  • TS Aukema,
  • V Baart,
  • EZ Barsom,
  • VP Bastiaenen,
  • T Bazuin,
  • MAJ Becker,
  • HJ Belgers,
  • VM Belvroy,
  • RHA Berndsen,
  • B Biersteker,
  • JDW Van der Bilt,
  • JG Bloemen,
  • S Bluiminck,
  • FC Den Boer,
  • EG Boerma,
  • MC Boonstra,
  • WAA Borstlap,
  • LA Brugts,
  • JWA Burger,
  • TA Burghgraef,
  • SMM De Castro,
  • M Cleveringa,
  • RJS Coelen,
  • JWT Dekker,
  • A Demirkiran,
  • E Dijkema,
  • S Dijkink,
  • SA Dingemans,
  • L Van Dullemen,
  • EB Van Duyn,
  • AJ Eleveld,
  • HA Galema,
  • EGM Van Geffen,
  • RTJ Geitenbeek,
  • AAW Van Geloven,
  • AHC Gielen,
  • CA Gispen,
  • MJPM Govaert,
  • WMU Van Grevenstein,
  • BA Grotenhuis,
  • AAJ Grüter,
  • SF Hardon,
  • AG DenHartog,
  • K Havenga,
  • JAG Van der Heijden,
  • F Heilijgers,
  • TBM Van den Heuvel,
  • RS Hijmans,
  • J Van Hilst,
  • I Hochstenbach,
  • C Hoff,
  • JC Hol,
  • S Janki,
  • ACHM Jongen,
  • I Kappers,
  • S Karhof,
  • BAJ Kertzman,
  • MM Kieboom,
  • N Koemans,
  • JLM Konsten,
  • WH Kopp,
  • OW Kranenburg,
  • P Krielen,
  • A Kumas,
  • M Kusters,
  • DPV Lambrichts,
  • B Lamme,
  • GL Van Leeuwen,
  • JWA Leijtens,
  • EW Lockhorst,
  • H Lutfi,
  • S Malm,
  • HTJ Mantel,
  • GA Martini,
  • P Meijer,
  • J Melenhorst,
  • DM Mens,
  • MJH Metman,
  • LR Moolenaar,
  • LCF De Nes,
  • JA Nieuwstraten,
  • J Nonner,
  • SE Van Oostendorp,
  • SJ Oosterling,
  • KCMJ Peeters,
  • CMW Pesch,
  • CML Peters,
  • MWH Philipsen,
  • WY Van der Plas,
  • MM Poelman,
  • F Polat,
  • AE Posma-Bouman,
  • BB Pultrum,
  • JM Van Rees,
  • WP Reinders,
  • PR De Reuver,
  • MC Richir,
  • TWH Rijnhout,
  • MM Romeijn,
  • D Roorda,
  • CC Van Rossem,
  • J Rothbarth,
  • M Ruig,
  • HG Sahin,
  • I Said,
  • RA Schasfoort,
  • J Scholten,
  • JMJ Schreinemakers,
  • PME Schuivens,
  • D Schweitzer,
  • C Sietses,
  • M Sietzema,
  • GD Slooter,
  • N Smakman,
  • BP Smalbroek,
  • AB Smits,
  • EJ Spillenaar Bilgen,
  • EJA Steller,
  • TF Stoop,
  • M Straver,
  • SK Stuart,
  • A Suntharan,
  • AK Talsma,
  • K Trumpi,
  • JB Tuynman,
  • J Veenhuizen,
  • AWH Van de Ven,
  • EGG Verdaasdonk,
  • PM Verheijen,
  • A Villerius-Meijer,
  • M Vissers,
  • ELK Voogt,
  • RPH De Vries,
  • ST Van Vugt,
  • DD De Waard,
  • TR Wagner,
  • AK Warps,
  • RHA Welling,
  • M Westerterp,
  • JK Wiggers,
  • AR Wijsmuller,
  • CDM Witjes,
  • N Van Zenden,
  • DDE Zimmerman,
  • SJM Zomer,
  • ES Zwanenburg,
  • ES Zwart,
  • SLM Zwetsloot,
  • IHJT de Hingh,
  • NFM Kok,
  • MJ Lahaye,
  • OW Kranenburg,
  • AGJ Aalbers,
  • P Snaebjornsson,
  • IHJT de Hingh,
  • NFM Kok,
  • MJ Lahaye,
  • OW Kranenburg,
  • AGJ Aalbers,
  • P Snaebjornsson

摘要

Background

Organ preservation is gaining attention, yet primary treatment approaches differ substantially between pT1 and pT2 colon cancer (CC). This study evaluates whether tumor invasion depth affects survival outcomes in patients with pT1-2N0-2 colon cancer.

Methods

In this nationwide cohort study, patients undergoing surgery for pT1 or pT2 CC between 2014 and 2015 were identified from the Dutch Snapshot Research Group’s SNAPSHOT complex colon cancer database. Five-year disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazard models.

Results

A total of 2312 patients were included (921 pT1 and 1391 pT2). Five-year DFS (83.5% vs. 83.2%, P = 0.79, adjusted HR [HRadj] pT2 vs. pT1: 0.9; 95% confidence interval [CI] 0.7–1.2) and 5-year OS (84.9% vs. 85.6%, P = 0.72, HRadj pT2 vs. pT1: 0.8; 95% CI 0.6–1.1) were comparable between pT1N0 and pT2N0 patients. Similarly, in pT1N+ and pT2N+ patients, there was no significant difference in DFS (81% vs. 75.8%, P = 0.31, HRadj pT2 vs. pT1: 1.3; 95% CI 0.6–2.6) or OS (84% vs. 82.5%, P = 0.73, HRadj pT2 vs. pT1: 0.9; 95% CI 0.5–1.6). Distant metastases developed in 37 (4%) pT1 patients and 68 (4.9%) pT2 patients (P = 0.33). Among these, 26 of 37 pT1 patients (70.3%) and 40 of 68 pT2 patients (58.8%) did not have lymph node metastases in the initial resection specimen (pN0).

Conclusions

Tumor invasion depth (pT1 or pT2) had no significant impact on DFS or OS following formal oncological resection. Furthermore, most distant metastases develop in pN0 patients, suggesting a minor influence of surgery on control of distant disease.