Prognostic Value of the Lymph Node Ratio in Rectal Cancer
Objective: The pathologic staging of rectal cancer is an important prognostic factor. A sufficient number of harvested lymph nodes is necessary for accurate staging. In patients with an insufficient number of dissected lymph nodes, the lymph node ratio (LNR) can be used as a prognostic factor. The a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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GESDAV
2014-08-01
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| Series: | Archives of Clinical and Experimental Surgery |
| Subjects: | |
| Online Access: | http://www.scopemed.org/fulltextpdf.php?mno=48449 |
| _version_ | 1797911927921311744 |
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| author | Mehmet Ince Yavuz Ozdemir Ahmet Ziya Balta Kazim Duman Ergun Yucel Ilker Sucullu Mehmet Levhi Akin |
| author_facet | Mehmet Ince Yavuz Ozdemir Ahmet Ziya Balta Kazim Duman Ergun Yucel Ilker Sucullu Mehmet Levhi Akin |
| author_sort | Mehmet Ince |
| collection | DOAJ |
| description | Objective: The pathologic staging of rectal cancer is an important prognostic factor. A sufficient number of harvested lymph nodes is necessary for accurate staging. In patients with an insufficient number of dissected lymph nodes, the lymph node ratio (LNR) can be used as a prognostic factor. The aim of this study was to determine the effect of the LNR on the prognosis of patients with rectal cancer.
Materials and Methods: A total of 130 patients who had rectal adenocarcinoma and who underwent surgery between 1996 and 2011 were included in this study. Age, gender, serum carcinoembryonic antigen, type of surgery, and pathological features were retrieved retrospectively. Cut-off values for LNR were 1/12, 1/4, and 1/2; patients were stratified into four groups according to this ratio. The relationship between disease-free survival (DFS) and overall survival (OS) and LNR was investigated. Cumulative survival curves were calculated by the Kaplan Meier method, and survival differences between groups were calculated by the log-rank test.
Results: The mean number of lymph nodes examined was 11.5+/-8. In 75 of all patients (57.7%), fewer than 12 lymph nodes were harvested. Seventy-six patients (58.5%) were evaluated as N0, 35 (26.9%) were N1, and 19 (14.6%) were N2. The number of patients in these LNR groups was 87 (66.9%), 13 (10%), 17 (13.1%), and 13 (10%), respectively. The 5-year survival rate was found to be 72.3% in the LNR1 group, 55.6% in the LNR2 group, 44.4% in the LNR3 group, and 22.2% in the LNR4 group. The difference in OS and DFS rates was significant (p<0.001 for both).
Conclusion: The LNR for rectal cancer has a prognostic effect on both DFS and OS. Thus, it may be beneficial for adjuvant therapy decisions, especially in patients with an insufficient number of dissected lymph nodes. [Arch Clin Exp Surg 2014; 3(4.000): 207-212] |
| first_indexed | 2024-04-10T11:48:23Z |
| format | Article |
| id | doaj.art-59ba5fd0cb9a4dc3aa3757e561460861 |
| institution | Directory Open Access Journal |
| issn | 2146-8133 |
| language | English |
| last_indexed | 2024-04-10T11:48:23Z |
| publishDate | 2014-08-01 |
| publisher | GESDAV |
| record_format | Article |
| series | Archives of Clinical and Experimental Surgery |
| spelling | doaj.art-59ba5fd0cb9a4dc3aa3757e5614608612023-02-15T16:17:14ZengGESDAVArchives of Clinical and Experimental Surgery2146-81332014-08-013420721210.5455/aces.2014010202254248449Prognostic Value of the Lymph Node Ratio in Rectal CancerMehmet Ince0Yavuz Ozdemir1Ahmet Ziya Balta2Kazim Duman3Ergun Yucel4Ilker Sucullu5Mehmet Levhi Akin6Gulhane Military Hospital, Department of Emergency Medicine, Haydarpasa Gulhane Military Hospital, Department of General Surgery Haydarpasa Gulhane Military Hospital, Department of General Surgery Gumussuyu Military Hospital, Department of General Surgery Haydarpasa Gulhane Military Hospital, Department of General Surgery Haydarpasa Gulhane Military Hospital, Department of General Surgery Haydarpasa Gulhane Military Hospital, Department of General SurgeryObjective: The pathologic staging of rectal cancer is an important prognostic factor. A sufficient number of harvested lymph nodes is necessary for accurate staging. In patients with an insufficient number of dissected lymph nodes, the lymph node ratio (LNR) can be used as a prognostic factor. The aim of this study was to determine the effect of the LNR on the prognosis of patients with rectal cancer. Materials and Methods: A total of 130 patients who had rectal adenocarcinoma and who underwent surgery between 1996 and 2011 were included in this study. Age, gender, serum carcinoembryonic antigen, type of surgery, and pathological features were retrieved retrospectively. Cut-off values for LNR were 1/12, 1/4, and 1/2; patients were stratified into four groups according to this ratio. The relationship between disease-free survival (DFS) and overall survival (OS) and LNR was investigated. Cumulative survival curves were calculated by the Kaplan Meier method, and survival differences between groups were calculated by the log-rank test. Results: The mean number of lymph nodes examined was 11.5+/-8. In 75 of all patients (57.7%), fewer than 12 lymph nodes were harvested. Seventy-six patients (58.5%) were evaluated as N0, 35 (26.9%) were N1, and 19 (14.6%) were N2. The number of patients in these LNR groups was 87 (66.9%), 13 (10%), 17 (13.1%), and 13 (10%), respectively. The 5-year survival rate was found to be 72.3% in the LNR1 group, 55.6% in the LNR2 group, 44.4% in the LNR3 group, and 22.2% in the LNR4 group. The difference in OS and DFS rates was significant (p<0.001 for both). Conclusion: The LNR for rectal cancer has a prognostic effect on both DFS and OS. Thus, it may be beneficial for adjuvant therapy decisions, especially in patients with an insufficient number of dissected lymph nodes. [Arch Clin Exp Surg 2014; 3(4.000): 207-212]http://www.scopemed.org/fulltextpdf.php?mno=48449Lymph node ratiorectal cancer |
| spellingShingle | Mehmet Ince Yavuz Ozdemir Ahmet Ziya Balta Kazim Duman Ergun Yucel Ilker Sucullu Mehmet Levhi Akin Prognostic Value of the Lymph Node Ratio in Rectal Cancer Archives of Clinical and Experimental Surgery Lymph node ratio rectal cancer |
| title | Prognostic Value of the Lymph Node Ratio in Rectal Cancer |
| title_full | Prognostic Value of the Lymph Node Ratio in Rectal Cancer |
| title_fullStr | Prognostic Value of the Lymph Node Ratio in Rectal Cancer |
| title_full_unstemmed | Prognostic Value of the Lymph Node Ratio in Rectal Cancer |
| title_short | Prognostic Value of the Lymph Node Ratio in Rectal Cancer |
| title_sort | prognostic value of the lymph node ratio in rectal cancer |
| topic | Lymph node ratio rectal cancer |
| url | http://www.scopemed.org/fulltextpdf.php?mno=48449 |
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