Would you give adjuvant chemo for a mucinous stage II adenocarcinoma of the colon in the lack of other high-risk clinical pathological features?

The mucinous feature is reported to be a poor prognostic feature in colorectal cancer based on some retrospective series (e.g., Symonds and Vickery, PMID 177180, Green et al., PMID 8380140, Catalano et al., PMID 21531784, and Ott et al., PMID 29870979). However, there are some other studies suggesting the mucinous feature itself does not correlate with poor prognosis (Warschkow et al., PMID 26977857).

I would not recommend adjuvant chemotherapy for a stage II colon cancer patient based only on the mucinous feature. I would consider using ctDNA to guide adjuvant treatment decisions for stage II colon cancer based on the DYNAMIC study result (although for T4 disease, I would give adjuvant chemo irrespective of CT DNA result).