Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy.
To evaluate the prognostic impact of the lymph node ratio (LNR) in ypStage III rectal cancer patients who were treated with neoadjuvant chemoradiotherapy (NCRT).We retrospectively reviewed the data of 638 consecutive patients who underwent NCRT followed by total mesorectal excision, and postoperativ...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4575157?pdf=render |
| _version_ | 1828858060566691840 |
|---|---|
| author | Taeryool Koo Changhoon Song Jae-Sung Kim Kyubo Kim Eui Kyu Chie Sung-Bum Kang Keun-Wook Lee Jee Hyun Kim Seung-Yong Jeong Tae-You Kim |
| author_facet | Taeryool Koo Changhoon Song Jae-Sung Kim Kyubo Kim Eui Kyu Chie Sung-Bum Kang Keun-Wook Lee Jee Hyun Kim Seung-Yong Jeong Tae-You Kim |
| author_sort | Taeryool Koo |
| collection | DOAJ |
| description | To evaluate the prognostic impact of the lymph node ratio (LNR) in ypStage III rectal cancer patients who were treated with neoadjuvant chemoradiotherapy (NCRT).We retrospectively reviewed the data of 638 consecutive patients who underwent NCRT followed by total mesorectal excision, and postoperative adjuvant chemotherapy for rectal cancer from 2004 to 2011. Of these, 125 patients were positive for lymph node (LN) metastasis and were analyzed in this study.The median numbers of examined and metastatic LNs were 17 and 2, respectively, and the median LNR was 0.143 (range, 0.02-1). Median follow-up time was 55 months. In multivariate analyses, LNR was an independent prognostic factor for overall survival (OS) (hazard ratio [HR] 2.17, p = 0.041), disease-free survival (DFS) (HR 2.28, p = 0.005), and distant metastasis-free survival (DMFS) (HR 2.30, p = 0.010). When ypN1 patients were divided into low (low LNR ypN1 group) and high LNR (high LNR ypN1 group) according to a cut-off value of 0.152, the high LNR ypN1 group had poorer OS (p = 0.043) and DFS (p = 0.056) compared with the low LNR ypN1 group. And there were no differences between the high LNR ypN1 group and the ypN2 group in terms of the OS (p = 0.703) and DFS (p = 0.831).For ypN-positive rectal cancer patients, the LNR was a more effective prognostic marker than the ypN stage, circumferential resection margin, or tumor regression grade after NCRT, and could be used to discern the high-risk group among ypN1 patients. |
| first_indexed | 2024-12-13T01:49:15Z |
| format | Article |
| id | doaj.art-d4cdc33171ea487ba95ce9c5b778644e |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T01:49:15Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-d4cdc33171ea487ba95ce9c5b778644e2022-12-22T00:03:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01109e013872810.1371/journal.pone.0138728Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy.Taeryool KooChanghoon SongJae-Sung KimKyubo KimEui Kyu ChieSung-Bum KangKeun-Wook LeeJee Hyun KimSeung-Yong JeongTae-You KimTo evaluate the prognostic impact of the lymph node ratio (LNR) in ypStage III rectal cancer patients who were treated with neoadjuvant chemoradiotherapy (NCRT).We retrospectively reviewed the data of 638 consecutive patients who underwent NCRT followed by total mesorectal excision, and postoperative adjuvant chemotherapy for rectal cancer from 2004 to 2011. Of these, 125 patients were positive for lymph node (LN) metastasis and were analyzed in this study.The median numbers of examined and metastatic LNs were 17 and 2, respectively, and the median LNR was 0.143 (range, 0.02-1). Median follow-up time was 55 months. In multivariate analyses, LNR was an independent prognostic factor for overall survival (OS) (hazard ratio [HR] 2.17, p = 0.041), disease-free survival (DFS) (HR 2.28, p = 0.005), and distant metastasis-free survival (DMFS) (HR 2.30, p = 0.010). When ypN1 patients were divided into low (low LNR ypN1 group) and high LNR (high LNR ypN1 group) according to a cut-off value of 0.152, the high LNR ypN1 group had poorer OS (p = 0.043) and DFS (p = 0.056) compared with the low LNR ypN1 group. And there were no differences between the high LNR ypN1 group and the ypN2 group in terms of the OS (p = 0.703) and DFS (p = 0.831).For ypN-positive rectal cancer patients, the LNR was a more effective prognostic marker than the ypN stage, circumferential resection margin, or tumor regression grade after NCRT, and could be used to discern the high-risk group among ypN1 patients.http://europepmc.org/articles/PMC4575157?pdf=render |
| spellingShingle | Taeryool Koo Changhoon Song Jae-Sung Kim Kyubo Kim Eui Kyu Chie Sung-Bum Kang Keun-Wook Lee Jee Hyun Kim Seung-Yong Jeong Tae-You Kim Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy. PLoS ONE |
| title | Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy. |
| title_full | Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy. |
| title_fullStr | Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy. |
| title_full_unstemmed | Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy. |
| title_short | Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy. |
| title_sort | impact of lymph node ratio on oncologic outcomes in ypstage iii rectal cancer patients treated with neoadjuvant chemoradiotherapy followed by total mesorectal excision and postoperative adjuvant chemotherapy |
| url | http://europepmc.org/articles/PMC4575157?pdf=render |
| work_keys_str_mv | AT taeryoolkoo impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT changhoonsong impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT jaesungkim impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT kyubokim impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT euikyuchie impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT sungbumkang impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT keunwooklee impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT jeehyunkim impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT seungyongjeong impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy AT taeyoukim impactoflymphnoderatioononcologicoutcomesinypstageiiirectalcancerpatientstreatedwithneoadjuvantchemoradiotherapyfollowedbytotalmesorectalexcisionandpostoperativeadjuvantchemotherapy |