International Journal of Colorectal Disease

, Volume 24, Issue 11, pp 1297–1302

Metastatic lymph node ratio is a more precise predictor of prognosis than number of lymph node metastases in stage III colon cancer

Authors

  • Chih-Chien Chin
    • Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial Hospital
    • Graduate Institute of Clinical Medical Science, College of MedicineChang Gung University
    • Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial Hospital
    • Graduate Institute of Clinical Medical Science, College of MedicineChang Gung University
  • Chien-Yuh Yeh
    • Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial Hospital
    • Graduate Institute of Clinical Medical Science, College of MedicineChang Gung University
  • Yi-Hung Kuo
    • Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial Hospital
  • Wen-Shih Huang
    • Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial Hospital
    • Graduate Institute of Clinical Medical Science, College of MedicineChang Gung University
  • Chung-Hung Yeh
    • Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial Hospital
Original Article

DOI: 10.1007/s00384-009-0738-7

Cite this article as:
Chin, C., Wang, J., Yeh, C. et al. Int J Colorectal Dis (2009) 24: 1297. doi:10.1007/s00384-009-0738-7

Abstract

Objective

The objective of this study is to assess the value of metastatic lymph node ratio (LNR) in predicting disease-free survival (DFS) in patients with stage III adenocarcinoma of the colon.

Materials and methods

From 1995 to 2003 inclusively, a total of 624 patients featuring stage III adenocarcinoma of the colon underwent curative resection. Of the 624 patients, an adequate number of lymph nodes (n ≥ 12) had been harvested in 490 patients. These patients were stratified into LNR groups 1 (LNR ≤ 0.4), 2 (0.4 < LNR ≤ 0.7), and 3 (LNR > 0.7). Kaplan–Meier survival curve and log-rank test were used to evaluate the prognostic value of LNR. A Cox regression model was used for multivariate analyses.

Results

The 5-year DFS rate was 66.7% for patients with LNR1, 35.1% for those with LNR2, and 0% for patients with LNR3 (p < 0.0001). In T3/4LNR1 patients (n = 411), there was no difference in survival between those with N1 stage and those with N2 stage. Cox proportional hazards regression analysis revealed that N stage (number of positive lymph nodes) was not a significant factor when LNR was taken into consideration.

Conclusions

LNR is a more precise predictor of 5-year DFS than number of positive lymph nodes (N stage) in patients with stage III colon cancer.

Keywords

Lymph node ratioColon cancer

Copyright information

© Springer-Verlag 2009