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

  • Chih-Chien Chin
  • Jeng-Yi Wang
  • Chien-Yuh Yeh
  • Yi-Hung Kuo
  • Wen-Shih Huang
  • Chung-Hung Yeh
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

Authors and Affiliations

  • Chih-Chien Chin
    • 1
    • 3
  • Jeng-Yi Wang
    • 1
    • 3
  • Chien-Yuh Yeh
    • 2
    • 3
  • Yi-Hung Kuo
    • 1
  • Wen-Shih Huang
    • 1
    • 3
  • Chung-Hung Yeh
    • 1
  1. 1.Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial HospitalPutz CityTaiwan
  2. 2.Division of Colon and Rectal Surgery, Department of SurgeryChang Gung Memorial HospitalLinkouTaiwan
  3. 3.Graduate Institute of Clinical Medical Science, College of MedicineChang Gung UniversityTaoyuanTaiwan