Added value of adjuvant chemotherapy in patients with node-positive pT1-2 Colon cancer — A national SNAPSHOT analysis
Abstract BACKGROUND Patients with node-positive colon carcinoma commonly receive adjuvant chemotherapy, regardless the tumor’s T-stage. However, early-stage tumors (pT1-2 CC) are largely underrepresented in landmark studies supporting this treatment. This study evaluates the application of adjuvant chemotherapy in those patients based on daily practice. PATIENTS AND METHODS Patients who underwent surgery for either pT1- or pT2-CC were identified from the nationwide SNAPSHOT database and stratified by age (<75 or ≥ 75 years). Competing risk regression and (cause-specific) Cox proportional hazard models identified factors associated with 5-year cumulative incidence of recurrence and overall survival (OS), respectively. RESULTS Lymph node metastases were found in 381 out of 2,312 (16.5%) patients, of whom 275 (72.2%) received adjuvant chemotherapy. The cumulative incidence of recurrence was 0.09 (95%CI 0.06–0.12) and 0.18 (95%CI 0.11–0.27) in patients who did or did not receive adjuvant chemotherapy, respectively (P=.007). In patients under 75, adjuvant chemotherapy was associated with significantly higher OS (91.3% vs. 68.1%, P<.001). Corresponding OS probabilities in elderly patients (≥75 years) were 84.5% vs. 55.1%, P=.003. After adjusting for confounding, this difference remained only significant in patients under 75: HRadj 0.5, 95%CI 0.1–0.7 and HRadj 0.5, 95%CI 0.2–1.3, respectively. The recurrence rate was not significantly different between patients receiving Capecitabine/Oxaliplatin (CapOx) and those on Capecitabine monotherapy (CIF 0.09, 95% CI 0.06-0.14 vs. 0.05, 95%CI 0.01-0.16, P = 0.49) CONCLUSION Adjuvant chemotherapy is associated with reduced risk of recurrence in patients with node-positive pT1-2 CC. Advantages on OS could not be demonstrated in elderly pT1-2N1-2 patients.
Authors
- Eva Rademaker (ORCID: https://orcid.org/0000-0002-9083-2550)
- Jan W B de Groot
- Bobby Zamaray (ORCID: https://orcid.org/0000-0002-2361-7578)
- Julia Hanevelt (ORCID: https://orcid.org/0000-0001-7418-9190)
- Esther C J Consten
- Wouter H de Vos Tot Nederveen Cappel
- J Nonner
- J W A Burger
- H A Galema
- A A J Grüter
- P Meijer
- L Van Dullemen
- L R Moolenaar
- E G M Van Geffen
- J D W Van der Bilt
- S Bluiminck
- S Janki
- J Van Hilst
- D P V Lambrichts
- D M Mens
- J W T Dekker
- W A A Borstlap
- M J P M Govaert
- F J Amelung
- B A J Kertzman
- Frank P Vleggaar
- V Baart
- B A Grotenhuis
- R S Hijmans
- B Biersteker
- I Hochstenbach
- M A J Becker
- W H Kopp
- J G Bloemen
- G A Martini
- A G Den Hartog
- H T J Mantel
- O W Kranenburg
- T S Aukema
- Leon M G Moons
- Richard M Brohet
- M Kusters
- M M Kieboom
- J C Hol
- M C Boonstra
- C A Gispen
- E Z Barsom
- E W Lockhorst
- J J Atema
- M J H Metman
- F C Den Boer
- W M U Van Grevenstein
- R J S Coelen
- P Krielen
- R T J Geitenbeek
- F Heilijgers
- E B Van Duyn
- N Koemans
- K Havenga
- S M M De Castro
- B Lamme
- D C Van der Aa
- T A Burghgraef
- E G Boerma
- A H C Gielen
- A Kumas
- E Ancion
- A C H M Jongen
- S F Hardon
- E Dijkema
- V M Belvroy
- S Karhof
- I Kappers
- Henderik L van Westreenen
- L A Brugts
- A A W Van Geloven
- J A G Van der Heijden
- S Dijkink
- Pieter J Tanis
- R H A Berndsen
- C Hoff
- T Bazuin
- M Cleveringa
- J A Nieuwstraten
- S M Van Aalten
- J W A Leijtens
- T B M Van den Heuvel
- L C F De Nes
- S A Dingemans
- P Van Amstel
- A Demirkiran
- G L Van Leeuwen
- V P Bastiaenen
- H J Belgers
- J Melenhorst
- S Malm
- J L M Konsten
- A J Eleveld
- I Aanen
- H Lutfi
Institutions
- University Medical Center Groningen (NL)
- Utrecht University (NL)
- University Medical Center Utrecht (NL)
- Isala (NL)
- Erasmus MC Cancer Institute (NL)
- Meander Medisch Centrum (NL)
- Andalas University (ID)
Publication Details
- Journal
- The Oncologist
- Published
- 2026-05-12
- DOI
- https://doi.org/10.1093/oncolo/oyag171
- Primary Topic
- Colorectal Cancer Surgical Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00