Lymph-node ratio is an independent prognostic factor in patients with stage III colorectal cancer: a retrospective study from the Middle East

World Journal of Surgical Oncology

Ali Shamseddine⁶  AhmadSaleh⁶  Ghassan K Abou‒Alfa⁴  Hasan Hattoum²  Mohamad Eloubeidi¹  Hani Dimassi³  Mohammad Khalife⁵  Walid Faraj⁵  Deborah Mukherji⁶  Elias Elias⁶ 

[1] Division of Gastroenterology, Department of Internal Medicine, American University of Beirut, Riad El-Solh, Beirut, 1107 2020, Lebanon;Department of Internal Medicine, Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY, 10305, USA;School of Pharmacy, Lebanese American University, Byblos, Lebanon;Memorial Sloan-Kettering Cancer Center, Section of Gastrointestinal Oncology, New York, NY, USA;Division of Hepatobiliary and Gastric surgery, Department of General Surgery, American University of Beirut, Riad El-Solh, Beirut, 1107 2020, Lebanon;Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut, Riad El-Solh, Beirut, 1107 2020, Lebanon

关键词: Prognosis;    Lymph node ratio;    Stage III;    Colorectal cancer;   

Others  :  827866
DOI  :  10.1186/1477-7819-10-63

 received in 2011-12-09, accepted in 2012-04-25,  发布年份 2012

【 摘 要 】

Background

In this retrospective study, we evaluated the prognostic effect of positive lymph-node ratio (pLNR) on patients with stage III colorectal cancer (CRC). Our paper is the first analysis, to our knowledge, to deal with such data from the Middle East.

Methods

We analyzed the clinicopathological data of 535 patients diagnosed with colorectal cancer at our institution between 1983 and 2003. The 164 patients diagnosed with stage III disease were divided into two categories based on lymph-node ratio (LNR) being the ratio of positive lymph nodes over total lymph nodes dissected: LNR ≤0.4 and LNR >0.4. We used Kaplan-Meier and Cox proportional hazard models to evaluate the prognostic effect of pLNR.

Results

The 10-year survival rate for the patients with stage IIIA, IIIB and IIIC cancers were 76%, 56% and 0% respectively (P = 0.014). Using pLNR of 0.4 as the cutoff point was found to yield clinically and significant results, with a significant difference in the outcomes of patients with pLNR ≤0.4 compared to those with pLNR >0.4 (hazard ratio = 5.25, 95% confidence interval = 1.2 to 22.1, P = 0.02).

Conclusion

The ratio-based staging (pLNR) of CRC is a more accurate and clinically useful prognostic method than the number of positive LNs resected or the total number of LNs retrieved for predicting the course of patients with stage III CRC.

【 授权许可】

   
2012 Elias et al.; licensee BioMed Central Ltd.

【 图 表 】

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