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This study assesses whether tumor size affects recurrence-free survival (RFS) and overall survival (OS) in patients with stage T3N1 colon cancer. Using a retrospective cohort of 336 pT3N1 patients treated with curative resection (2015–2025), tumor size was pathologically measured and analyzed with ROC, Kaplan–Meier, and Cox regression models.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/prognostic-impact-of-tumor-size-in-patients-with-stage-t3n1-colon-cancer/461493/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/prognostic-impact-of-tumor-size-in-patients-with-stage-t3n1-colon-cancer/461493.png","ImageObject",300,407,{"name":92,"@type":93},"pop out","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How was tumor size used in this study, and how was the cutoff determined?","Question",{"text":112,"@type":113},"Tumor size was measured pathologically, and an optimal cutoff predicting recurrence was determined using receiver operating characteristic (ROC) analysis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What impact did larger tumor size have on recurrence-free survival (RFS)?",{"text":117,"@type":113},"Patients with tumors ≥ 4 cm had significantly lower 5-year RFS than those with smaller tumors (65.1% vs. 80.3%, p = 0.007).",{"name":119,"@type":110,"acceptedAnswer":120},"Was tumor size independently associated with overall survival (OS)?",{"text":121,"@type":113},"No. Tumor size was not independently associated with OS (p = 0.46).","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461493,1790811389,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090760408,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Article  \nPrognostic Impact of Tumor Size in Patients with Stage T3N1 Colon Cancer  \nEzgi Turkoglu 1, *, Nisanur Sarıyar Busery 1, Sedat Yildirim 1, Goncagül Akda ˘g Topal 2, Cevher Burcu Salman 1, Erhan Conay 1, Furkan Turkoglu 3, Ozhan Albayrak 4, Seval Ay Ersoy 1, Deniz Isik 1, Hatice Odaba¸s 1, Cihad Tatar 5 and Nedim Turan 1  \nAcademic Editor: Hiroyuki Yoshida  \nReceived: 5 December 2025  \nRevised: 23 December 2025  \nAccepted: 24 December 2025  \nPublished: 29 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, 34865 ˙Istanbul, Türkiye  \n2 Department of Medical Oncology, Tokat State Hospital, 60100 Tokat, Türkiye  \n3 Department of General Surgery, Aktif International Hospital, 41275 Kocaeli, Türkiye  \n4 Department of General Surgery, Yozgat City Hospital, 66100 Yozgat, Türkiye  \n5 Independent Researcher, Canberra, ACT 2605, Australia  \n* Correspondence: [ezgiturk_90@hotmail.com](ezgiturk_90@hotmail.com)  \nAbstract  \nBackground/Objectives: Tumor size is not included in the TNM staging system for colon cancer, and its prognostic significance remains controversial. We aimed to evaluate the impact of tumor size on recurrence-free survival (RFS) and overall survival (OS) in patients with stage T3N1 colon cancer. Methods: We retrospectively analyzed 336 patients with pathologically confirmed pT3N1 colon cancer who underwent curative resection between January 2015 and January 2025 at our tertiary institution. Clinicopathological features, adjuvant chemotherapy details, and survival outcomes were collected. Tumor size was measured pathologically, and a cutoff was determined by receiver operating characteristic (ROC) analysis. Kaplan–Meier and Cox regression analyses were performed to identify prognostic factors. Results: The optimal cutoff for tumor size predicting recurrence was 4 cm. Patients with tumors ≥ 4 cm had significantly lower 5-year RFS compared to those with smaller tumors (65.1% vs. 80.3%, p = 0.007) . In multivariate analysis, tumor size ≥ 4 cm (HR: 2.014, 95% CI: 1.093–3.714, p = 0.025), ECOG performance status ≥ 2 (p = 0.005), positive resection margin (p = 0.011), and failure to complete adjuvant chemotherapy (p = 0.007) were identified as independent adverse prognostic factors for RFS. Tumor size was not independently associated with OS (p = 0.46) . Adjuvant chemotherapy significantly improved both RFS (p \u003C 0.001) and OS (p \u003C 0.001) . Conclusions: In patients with stage T3N1 colon cancer, tumor size ≥ 4 cm is an independent adverse prognostic factor for RFS. Incorporating tumor size into risk stratification, alongside TNM staging and treatment completion status, may improve prognostic assessment and guide clinical decision-making.  \nKeywords: colon cancer; T3N1 stage; tumor size; prognosis; recurrence-free survival; adjuvant chemotherapy  \n1. Introduction  \nColorectal cancer is a major global health issue and has been reported as the third most common malignancy in men and the second most common in women worldwide [1] . Locally advanced colorectal cancer accounts for approximately 5–22% of all colorectal cancer cases [2] . These tumors are classified using the Tumor–Node–Metastasis (TNM) staging  \nsystem, which plays a key role in predicting disease prognosis and guiding appropriate treatment strategies [3] .  \nIn colorectal cancer, the T factor is determined by the depth of vertical invasion, while the prognostic importance of tumor size, which indicates horizontal extension, remains uncertain. Several studies in the literature have shown that larger tumor size may act asan unfavorable prognostic factor [4,5] . However, especially in stage IIA disease, smaller tumors have been found to behave more aggressively biologically and may be linked to wor","cbCaiojpPNIo0LOX","https://ap.wps.com/l/cbCaiojpPNIo0LOX","pdf",837805,14,"English","# Abstract\n# Introduction","[{\"question\":\"How was tumor size used in this study, and how was the cutoff determined?\",\"answer\":\"Tumor size was measured pathologically, and an optimal cutoff predicting recurrence was determined using receiver operating characteristic (ROC) analysis.\"},{\"question\":\"What impact did larger tumor size have on recurrence-free survival (RFS)?\",\"answer\":\"Patients with tumors ≥ 4 cm had significantly lower 5-year RFS than those with smaller tumors (65.1% vs. 80.3%, p = 0.007).\"},{\"question\":\"Was tumor size independently associated with overall survival (OS)?\",\"answer\":\"No. Tumor size was not independently associated with OS (p = 0.46).\"}]","Prognostic Impact of Tumor Size in Patients with Stage T3N1 Colon Cancer | PDF",1790761724,35]