Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative Resection

INTRODUCTION: Metastatic lymph node ratio (mLNR) has been shown to be an important prognostic factor in some solid tumours. The aim of this study was to investigate the prognostic value of mLNR in patients with colorectal carcinoma (CRC). METHODS: The records of 246 CRC patients who had not distant...

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Main Authors: Kaptan Gülben, Osman Uyar, Bahadır Öndeş
Format: Article
Language:English
Published: Van Yuzuncu Yil University, School of Medicine 2022-01-01
Series:Van Tıp Dergisi
Subjects:
Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=vtd&un=VTD-24855
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author Kaptan Gülben
Osman Uyar
Bahadır Öndeş
author_facet Kaptan Gülben
Osman Uyar
Bahadır Öndeş
author_sort Kaptan Gülben
collection DOAJ
description INTRODUCTION: Metastatic lymph node ratio (mLNR) has been shown to be an important prognostic factor in some solid tumours. The aim of this study was to investigate the prognostic value of mLNR in patients with colorectal carcinoma (CRC). METHODS: The records of 246 CRC patients who had not distant metastasis and treated with curative surgery were retrospectively evaluated between January 2008 and April 2014. The effects of age, gender, the number of total lymph nodes removed, the number of metastatic lymph nodes, pathological T stage, TNM staging, mLNR and lymphovascular invasion on disease free survival and overall survival were analyzed with univariate and multivariate Cox-regression tests. Survival curves were calculated using Kaplan-Meier method and survival differences were assessed by log-rank test. Optimal cut-off value for mLNR is determined with ROC analysis. RESULTS: Median age was 61 (23-86) and median follow-up period was 38 (11-78) months. Optimal cut-off value for mLNR was found as 0,08 in ROC analysis. In the multivariate analysis, the number of total lymph nodes removed (p<0.007) and mLNR (HR, 2.1; 95% CI, 1.2-4.2; p<0.003) were found to be independent risk factors on disease-free survival. For overall survival, mLNR only was the independent risk factor on overall survival (HR,7.5; 95% CI, 2.6-21.2; p<0.0001). DISCUSSION AND CONCLUSION: mLNR value more than 0,08 was found to be an independent risk factor on both overall survival and disease-free survival in patients with non-metastatic CRC. Larger prospective studies are needed to support the significance of mLNR for TNM classification of CRC.
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spelling doaj.art-ab5a1c781e834a8bb6c2a745c08ffb3d2023-12-02T06:03:42ZengVan Yuzuncu Yil University, School of MedicineVan Tıp Dergisi2587-03512022-01-01291364010.5505/vtd.2022.24855VTD-24855Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative ResectionKaptan Gülben0Osman Uyar1Bahadır Öndeş2University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of General Surgery, Division of Surgical OncologyManisa Private Grandmedical Hospital, Department of General SurgeryMalatya Training and Research Hospital, Department of General SurgeryINTRODUCTION: Metastatic lymph node ratio (mLNR) has been shown to be an important prognostic factor in some solid tumours. The aim of this study was to investigate the prognostic value of mLNR in patients with colorectal carcinoma (CRC). METHODS: The records of 246 CRC patients who had not distant metastasis and treated with curative surgery were retrospectively evaluated between January 2008 and April 2014. The effects of age, gender, the number of total lymph nodes removed, the number of metastatic lymph nodes, pathological T stage, TNM staging, mLNR and lymphovascular invasion on disease free survival and overall survival were analyzed with univariate and multivariate Cox-regression tests. Survival curves were calculated using Kaplan-Meier method and survival differences were assessed by log-rank test. Optimal cut-off value for mLNR is determined with ROC analysis. RESULTS: Median age was 61 (23-86) and median follow-up period was 38 (11-78) months. Optimal cut-off value for mLNR was found as 0,08 in ROC analysis. In the multivariate analysis, the number of total lymph nodes removed (p<0.007) and mLNR (HR, 2.1; 95% CI, 1.2-4.2; p<0.003) were found to be independent risk factors on disease-free survival. For overall survival, mLNR only was the independent risk factor on overall survival (HR,7.5; 95% CI, 2.6-21.2; p<0.0001). DISCUSSION AND CONCLUSION: mLNR value more than 0,08 was found to be an independent risk factor on both overall survival and disease-free survival in patients with non-metastatic CRC. Larger prospective studies are needed to support the significance of mLNR for TNM classification of CRC.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=vtd&un=VTD-24855colorectal cancermetastatic lymph node ratioprognostic factors
spellingShingle Kaptan Gülben
Osman Uyar
Bahadır Öndeş
Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative Resection
Van Tıp Dergisi
colorectal cancer
metastatic lymph node ratio
prognostic factors
title Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative Resection
title_full Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative Resection
title_fullStr Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative Resection
title_full_unstemmed Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative Resection
title_short Prognostic Significance of Ratio of Metastatic Lymph Nodes in Colorectal Cancer Patients Treated with Curative Resection
title_sort prognostic significance of ratio of metastatic lymph nodes in colorectal cancer patients treated with curative resection
topic colorectal cancer
metastatic lymph node ratio
prognostic factors
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=vtd&un=VTD-24855
work_keys_str_mv AT kaptangulben prognosticsignificanceofratioofmetastaticlymphnodesincolorectalcancerpatientstreatedwithcurativeresection
AT osmanuyar prognosticsignificanceofratioofmetastaticlymphnodesincolorectalcancerpatientstreatedwithcurativeresection
AT bahadırondes prognosticsignificanceofratioofmetastaticlymphnodesincolorectalcancerpatientstreatedwithcurativeresection