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Impact of Adjuvant Chemotherapy on Overall Survival in Early-Onset Stage II-III Mucinous Adenocarcinoma of The Colon: A Propensity-Based Analysis.

Created on 26 Jul 2026

Authors

Usama Waqar, Manali Rupji, Musa Salar, Hashim Salar, Courtney L Devin, Terrah J Paul Olson, Yuan Liu, Patrick Sullivan, Seth A Rosen

Published in

Journal of surgical oncology. Jul 26, 2026. Epub Jul 26, 2026.

Abstract

Incidence of early-onset colon cancer is rising. Younger patients often present with advanced disease and distinct molecular profiles. Mucinous adenocarcinoma (MAC) represents a biologically unique subtype that may demonstrate limited responsiveness to adjuvant chemotherapy (AC). This study evaluated association between AC and overall survival (OS) in patients with early-onset stage II and III MAC.
Patients aged < 50 years diagnosed with stage II-III MAC were identified from NCDB (2006-2020). Stage II was categorized as high- or low-risk, with high-risk defined by presence of ≥ 1 of: < 12 lymph nodes retrieved, lymphovascular/perineural invasion, poor differentiation, or pT4 disease. Stabilized inverse probability of treatment weighting, Kaplan-Meier analysis, and multivariable Cox regression were performed to assess the association between AC and OS.
Among 3333 patients, 42.9% were stage II and 57.1% stage III. AC was administered to 70.1% of patients, including 41.3% with stage II and 91.7% with stage III disease. AC was not associated with improved OS in either high-risk or low-risk stage II subgroups but was significantly associated with improved OS in stage III disease (HR 0.71, 95% CI 0.54-0.93).
AC was associated with improved survival in stage III but not stage II early-onset MAC, including those with high-risk features.

PMID:
42502895
Bibliographic data and abstract were imported from PubMed on 26 Jul 2026.

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