Tumor aggression-defense index–a novel indicator to predicts recurrence and survival in stage II-III colorectal cancer

• DOI: 10.1186/s12967-025-06141-x
• Publication Date: 2025-01-22T17:02:25Z
• Authors: Tong Wu; Lin Fang; Yuli Ruan; Mengde Shi; Dan Su; Yue Ma; Ming Ma; Bojun Wang; Yuanyu Liao; Shuling Han; Xiaolin Lu; Chunhui Zhang; Chao Liu; Yanqiao Zhang
• Keywords: Cancer recurrence

Although the TNM staging system plays a critical role in guiding adjuvant chemotherapy for colorectal cancer (CRC), its precision risk stratification stage II and III CRC patients with proficient DNA mismatch repair (pMMR) remains limited. Therefore, precise predictive models research on postoperative treatments are crucial enhancing patient survival improving quality of life. This retrospective study analyzed 1051 pMMR who underwent radical resection were randomly assigned to training (n = 736) validation 315) groups. Immunohistochemistry hematoxylin eosin staining utilized evaluate regulatory-Immunoscore (RIS), tertiary lymphoid structures (TLS), tumor budding (TB). The Tumor Aggression-Defense Index (TADI) was derived through multi-factor COX regression model. Subgroup analysis demonstrated potential TADI personalized therapy CRC. Univariate multivariate Cox indicated that an independent prognostic indicator. Among CRC, significantly correlated improved recurrence times individuals intermediate (95% CI 0.19–0.59, P < 0.001) high 0.36–0.95, 0.031) TADI. In receiving chemotherapy, duration 3 months or longer notably associated prolonged time those 0.40–0.98, 0.041) compared durations less than months. serves as effective parameter predicting outcomes I-III treatment strategies.