Definitions of "high risk" stage II colon cancer from expert groups

	ASCO (2022)	NCCN (2022)	ESMO (2020)
T4 primary tumor	+	+	+ (major)
Inadequately sampled nodes	+ (<12)	+ (<12)	+ (major) (<12)
Poorly differentiated or undifferentiated tumor*	+	+	+ (minor)
Perforation	+	+ (localized)	+ (major)
Clinical obstruction	+	+	+ (minor)
LVI	+	+	+ (minor)
PNI	+	+	+ (minor)
Close/indeterminate or positive margins		+
High preoperative levels of serum CEA			+ (minor)
High tumor budding score (BD3, ≥10 buds)	+

ASCO: American Society of Clinical Oncology; NCCN: National Comprehensive Cancer Network; ESMO: European Society for Medical Oncology; LVI: lymphovascular invasion; PNI: perineural invasion; CEA: carcinoembryonic antigen.
* Poorly differentiated or undifferentiated histology (only a high risk feature for tumors with proficient mismatch repair/no microsatellite instability).

Graphic 90035 Version 8.0

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Definitions of "high risk" stage II colon cancer from expert groups