Patients with T4N0 colon cancer have a high risk of recurrence. It is the only version of stage III colon cancer that does not require a person to have involved lymph nodes. The additional adjuvant chemotherapy portion of treatment is extremely important since the likelihood of recurrence is higher than in patients with smaller tumors that have involved lymph nodes (T1-2N1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683985/pdf/ECAM2022-4088117.pdf