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

IF 2.4 3区医学 Q3 ONCOLOGY

International Journal of Clinical Oncology Pub Date : 2025-03-21 DOI:10.1007/s10147-025-02743-z

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

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引用次数: 0

Abstract

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.

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高风险 II 期和低风险 III 期结直肠癌的生存悖论和辅助化疗的效果。

目的：高危II期结直肠癌的预后可能比低危III期结直肠癌更差，而研究II期和III期亚组辅助化疗疗效的报告却很有限：利用多中心数据库，对2016年4月至2022年12月期间接受腹腔镜结直肠切除术、病理诊断为高风险II期（T4N0）或低风险III期（T1-2N1、T1-2N2、T3N1）的598例结直肠癌患者进行了回顾性研究：T4N0组中接受辅助化疗的患者较少（54.7/45.0/44.7/27.7%，P 结论：T4N0组中接受辅助化疗的患者较多（54.7/45.0/44.7/27.7%，P）：本项多中心研究显示，高危II期结直肠癌的预后可能比低危III期结直肠癌更差。T4N0结直肠癌可考虑术前治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Oncology 医学-肿瘤学

CiteScore

6.80

自引率

3.00%

发文量

175

审稿时长

2 months

期刊介绍： The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.