Neoadjuvant chemoradiotherapy has been established as the standard treatment for patients with locally advanced rectal cancer. However, the role of radiotherapy (RT) has not been fully confirmed in advanced colon cancer (LACC). We postulated that patients with pathological T4N2 locally advanced colon cancer would benefit more from RT. 6715 pT4N2M0 colon cancer patients were included in the Surveillance, Epidemiology, and End Results (SEER) database. The primary endpoints were 5-year overall survival (OS) and cancer-specific survival (CSS). Propensity score matching (PSM) with Kaplan-Meier and Cox proportional hazards' models was performed to estimate prognosis. Before PSM, patients underwent RT had better OS and CSS as compared to patients did not receive RT (OS: 40.1% vs 27.6%, p < .001; CSS: 49.6% vs 41.1%, p = .002). After PSM, 239 matched pairs were formed for further analysis. RT group also presented significantly improved prognosis (OS: 40.1% vs 25.7%, p = .008; CSS: 49.6% vs 38.2%, p = .042). Multivariable Cox regression analysis showed that RT was a protective factor [OS：Hazard ratio (HR) =0.677, 95% Confidence interval (CI): 0.532-0.862, p = .002; CSS: HR = 0.708, 95% CI: 0.533-0.941, p = .018]. For pT4N2M0 colon cancer patients, the addition of RT seems to confer survival benefit as compared to patients who did not receive RT.

中文翻译：

---

现代化学疗法时代辅助性放疗对病理性T4N2M0结肠癌的生存益处：来自SEER数据库2004-2015的证据。

新辅助放化疗已被确立为局部晚期直肠癌患者的标准治疗方法。但是，在晚期结肠癌（LACC）中尚未完全证实放射疗法（RT）的作用。我们假设病理性T4N2局部晚期结肠癌患者将从RT中获益更多。监测，流行病学和最终结果（SEER）数据库中包括6715名pT4N2M0结肠癌患者。主要终点是5年总生存期（OS）和癌症特异性生存期（CSS）。用Kaplan-Meier和Cox比例风险模型进行倾向得分匹配（PSM）来评估预后。与未接受RT的患者相比，PSM之前接受RT的患者的OS和CSS更好（OS：40.1％比27.6％，p <.001； CSS：49.6％vs 41.1％，p = .002）。在PSM之后，形成了239个匹配对，用于进一步分析。RT组的预后也显着改善（OS：40.1％vs 25.7％，p = .008； CSS：49.6％vs 38.2％，p = .042）。多变量Cox回归分析表明，RT是保护因子[OS：危险比（HR）= 0.677，95％可信区间（CI）：0.532-0.862，p = 0.002；CSS：HR = 0.708，95％CI：0.533-0.941，p = .018]。对于pT4N2M0结肠癌患者，与未接受RT的患者相比，增加RT似乎可以带来生存益处。95％CI：0.533-0.941，p = .018]。对于pT4N2M0结肠癌患者，与未接受RT的患者相比，增加RT似乎可以带来生存益处。95％CI：0.533-0.941，p = .018]。对于pT4N2M0结肠癌患者，与未接受RT的患者相比，增加RT似乎可以带来生存益处。