Advances and controversies in the management of T4 colon cancer

doi:10.3748/wjg.125373

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Evidence Review

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Dec 28, 2026; 32(48): 125373
Published online Dec 28, 2026. doi: 10.3748/wjg.125373

Advances and controversies in the management of T4 colon cancer

Long Li, Qing-Bin Kong, Xin Sui, Xin-Jian Wang

Long Li, Qing-Bin Kong, Xin Sui, Xin-Jian Wang, Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai 264400, Shandong Province, China

Co-corresponding authors: Xin Sui and Xin-Jian Wang.

Author contributions: Li L wrote the first draft of the manuscript and approved the final version; Kong QB performed the literature search; Sui X, Wang XJ reviewed the literature and revised this paper critically. Sui X and Wang XJ have made equal and critical contributions to the conceptualization and funding acquisition, and they will jointly take responsibility for the integrity of the entire data set.

AI contribution statement: AI tools, specifically (DeepSeek), were used solely for language polishing and formatting assistance. No AI tool was used to generate research data, interpret results, or formulate conclusions. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.

Conflict-of-interest statement: All authors declare no conflicts of interest.

Corresponding author: Xin-Jian Wang, Department of Gastrointestinal Surgery, Weihai Central Hospital, No. 3 Mishandong Road Xi, Wendeng District, Weihai 264400, Shandong Province, China. wdwxj@126.com

Received: July 6, 2026
Revised: August 15, 2026
Accepted: September 18, 2026
Published online: December 28, 2026
Processing time: 121 Days and 14.9 Hours

Core Tip

Core Tip: The overall prognosis for stage T4 colorectal cancer is poor. Neoadjuvant therapy and neoadjuvant immunotherapy may improve outcomes in locally advanced colorectal cancer. Due to the T4 stage and frequent discrepancies between pathological and clinical staging, treatment planning before and after surgery is often complicated. Imaging and intraoperative staging have relatively low overall accuracy but offer unique perspectives in distinguishing between T3 and T4 tumors.