would you recommend adjuvant chemotherapy for t1 t2 no colon cancer with poor prognostic factors eg poorly differentiated or lymphovascukar invasion
any evidence for an against
For IB colon cancer, pT2N0, no adjuvant treatment indicated. For stage Ii (pT3-4), only if high risk features after discussion with the patients.
Adjuvant treatment of colon cancer depends on the stage of the disease. Poor differentiation features, lymphovascular invasion or lymphovascular tumor emboli will not change the stage of the disease which means that they are not affecting the necessary adjuvant treatment, which is in that case nothing.
Stage II COLON cancer may be discussed to receive adjuvant treatment, if with high risk factors, such as Poor differentiation features, lymphovascular invasion or perineural invasion, pT4 , urgent surgery or under-representation of lymphnodes. So, not all stage II will receive adjuvant treatment, neither all II STAGE CASES should not receive that treatment. Since pT2N0 is stage one, surgery only is indicated dor cure intention tontreat. However, we must stress that not all same TNM stages are equal, and some additional factors are considered in the indication of (neo)adjuvant treatment, not only in colon cancer, but as in others also, such as breast, lung, prostate for example.
found this in research gate. Amazing
Prognostic factors in the patients with T2N0M0 colorectal cancer
Article in World Journal of Surgical Oncology 14(1) · December 2016
DOI: 10.1186/s12957-016-0826-4 · License: CC BY 4.0
Bin Xu
Bin Xu
Not on ResearchGate
Lin Yu
Lin Yu
Not on ResearchGate
Li-Zhong Zhao
Li-Zhong Zhao
Not on ResearchGate
Dong-Wang Ma
Dong-Wang Ma
Not on ResearchGate
Abstract
Background The 5-year survival rate of the patients with stage I colorectal cancer is about 90 %; therefore, adjuvant therapy has not been recommended after radical resection; however, about 16–26 % of T2N0M0 patients will be dead at 5 years despite radical curative resection. It indicated that there is a defined group of patients who are at high risk for relapse or metastasis despite radical operation. This study aimed to find the patients with T2N0M0 colorectal cancer at high risk for relapse or metastasis. Methods From January 1993 to December 2014, 812 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were eligible for this study. The medical records of all patients were collected and were retrospectively analyzed. Survival rates were calculated using Kaplan-Meier method, and survival cures were compared using the log-rank test. Cox proportional hazards model was used to analyze the significant factors defined in univariate test. Results The 5-year and 10-year overall survival rates were 81.9 and 67.7 %, respectively. Male gender, old age, lymphovascular permeation, perineural invasion, and poor differentiation were associated with low cancer-specific survival rates in Kaplan-Meier analysis. Multivariate analyses revealed old age, lymphovascular permeation, perineural invasion, and poor differentiation as significant independent factors predicting worse prognosis (P < 0.05). Conclusions Old age, lymphovascular permeation, perineural invasion, and poor differentiation are risk factors for the worse prognostic patients with T2N0M0 colorectal patients who would potential benefit from more aggressive therapy.
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