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. 2025 Dec 27;17(1):173.
doi: 10.1007/s12672-025-04219-y.

The impact of tumor-associated inflammatory adhesions on survival and treatment strategies in patients with colon cancer

Jinzhu Zhang #  1 , Jichuan Quan #  1 , Shucheng Liu #  2 , Zhixun Zhao  1 , Hengchang Liu  1 , Jianqiang Tang #  3 , Haipeng Chen #  4 , Xishan Wang #  5
Affiliations

The impact of tumor-associated inflammatory adhesions on survival and treatment strategies in patients with colon cancer

Jinzhu Zhang et al. Discov Oncol. .

Abstract

Purpose: In colon cancer patients with tumor-associated inflammatory adhesions (TAIA), the preoperative clinical staging is cT4b, but postoperative pathology reveals that the tumor has not invaded surrounding organs (non-pT4b). We aimed to investigate the impact of TAIA on prognosis and treatment strategies for colon cancer patients.

Methods: Colon cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database (2010 to 2019) and Chinese multicenter cohort were included to compare survival differences between the TAIA and non-TAIA groups. A Cox proportional hazards model was used to evaluate independent risk factors for survival in colon cancer patients. Additionally, we analyzed the impact of adjuvant chemotherapy on survival in TAIA patients.

Results: A total of 112,659 colon cancer patients from the SEER database and 881 colon cancer patients from the Chinese database were included in this study. After PSM, both cohorts found that patients in the TAIA group exhibited worse overall survival (P < 0.05) and cancer-specific survival (P < 0.05). Additionally, the Cox multivariate proportional hazards model identified TAIA as an independent risk factor for cancer-specific survival in colon cancer patients (SEER: HR 1.45, 95% CI: 1.40-1.50, P < 0.001; China: HR 2.108, 95% CI: 1.473-3.015, P < 0.001). Subsequently, 36,496 TAIA patients from the SEER database and 229 TAIA patients from a Chinese multicenter database were independently divided into adjuvant chemotherapy and control groups. After PSM, both databases indicated better survival in the adjuvant chemotherapy group.

Conclusion: Colon cancer patients with TAIA have a poorer prognosis. Adjuvant chemotherapy can improve the prognosis of TAIA patients.

Keywords: Adjuvant chemotherapy; Colon cancer; Prognosis; Tumor-associated inflammatory adhesions.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the ethics committee of Cancer Hospital, Chinese Academy of Medical Sciences (No. 22/442–3644). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent for publication: Not applicable. Informed consent: Informed consent was waived by the ethics committee of Cancer Hospital, Chinese Academy of Medical Sciences (No. 22/442–3644) due to the retrospective nature of the study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Kaplan–Meier curves presenting the survival difference between the TAIA and non-TAIA groups in the SEER. a Unadjusted OS of patients in the SEER cohort; b Unadjusted CSS of patients in the SEER cohort; c OS of patients in the SEER cohort after PSM; d CSS of patients in the SEER cohort after PSM. SEER Surveillance, Epidemiology, and End Results; PSM propensity score matching, TAIA tumor-associated inflammatory adhesions, OS overall survival, CSS cancer-specific survival
Fig. 3
Fig. 3
Multivariate COX analysis of OS of colon cancer patients in the SEER cohort. SEER Surveillance, Epidemiology, and End Results, TAIA tumor-associated inflammatory adhesions, OS Overall survival
Fig. 4
Fig. 4
Multivariate COX analysis of CSS of colon cancer patients in the SEER cohort. SEER Surveillance, Epidemiology, and End Results, TAIA tumor-associated inflammatory adhesions, CSS cancer-specific survival
Fig. 5
Fig. 5
Kaplan–Meier curves presenting the survival difference between the TAIA and non-TAIA groups in the Chinese cohort. a Unadjusted OS of patients in the Chinese cohort; b Unadjusted CSS of patients in the Chinese cohort; c OS of patients in the Chinese cohort after PSM; d CSS of patients in the Chinese cohort after PSM. PSM propensity score matching, TAIA tumor-associated inflammatory adhesions, OS overall survival, CSS cancer-specific survival
Fig. 6
Fig. 6
Kaplan–Meier curves presenting the survival difference between the adjuvant chemotherapy and control groups in TAIA patients. a OS of TAIA patients in the SEER cohort after PSM; b CSS of TAIA patients in the SEER cohort after PSM; c OS of TAIA patients in the Chinese cohort after PSM; d CSS of TAIA patients in the Chinese cohort after PSM. SEER Surveillance, Epidemiology, and End Results, PSM propensity score matching, TAIA tumor-associated inflammatory adhesions, OS overall survival, CSS cancer-specific survival
Fig. 7
Fig. 7
Multivariate COX analysis of OS of colon cancer patients with TAIA in the SEER cohort. TAIA tumor-associated inflammatory adhesions, OS overall survival, SEER Surveillance, Epidemiology, and End Results
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