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Prognostic Significance of the Metastatic Lymph Node Ratio in Node-Positive Rectal Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The purpose of the study was to evaluate the prognostic value of metastatic lymph node ratio (LNR) in node-positive rectal cancer.

Methods

A retrospective review was performed in 318 rectal cancer patients who received curative anterior resection in a single institution. Clinicopathological variables including LNR were studied in univariate and multivariate analyses by Cox regression. LNR was further studied when stratified by quartiles. Survival analyses were performed using the Kaplan–Meier method and log-rank test.

Results

With median follow-up of 41 months, the 5-year disease-free survival (DFS) rate, overall survival (OS) rate, and local recurrence (LR) rate were 56.82%, 59.8%, and 11%, respectively. Multivariate analysis revealed that LNR as a continuous variable was the most significant prognostic factor for DFS, OS, and LR. On quartiles, LNR was stratified into three groups: <0.14, 0.14–0.49, and 0.5–1. The 5-year DFS rate was 72.57%, 58.54%, and 34.75% (P = 0.0001) and the 5-year OS rate was 72.19%, 61.92%, and 38.47% (P = 0.002) in the three groups, respectively. Five-year LR rate was significantly higher with LNR between 0.14 and 1 (3.6% in LNR<0.14 versus 15.6% in LNR 0.14–1, P = 0.019).

Conclusions

LNR is an important prognostic factor for node-positive rectal cancers. With a cutoff of 0.14 and 0.5, node-positive rectal cancer patients could be categorized into three subsets with significant different outcomes.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Cancer Hospital, Fudan University, 270 Dong An Road, Shanghai, 200032, People’s Republic of China

    Junjie Peng MD, Ye Xu MD, Zuqing Guan MD, Minghe Wang MD, Guoxiang Cai MD & Sanjun Cai MD

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

    Junjie Peng MD, Ye Xu MD, Zuqing Guan MD, Ji Zhu MD, Minghe Wang MD, Guoxiang Cai MD, Weiqi Sheng MD & Sanjun Cai MD

  3. Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai, People’s Republic of China

    Ji Zhu MD

  4. Department of Pathology, Cancer Hospital, Fudan University, Shanghai, People’s Republic of China

    Weiqi Sheng MD

Authors
  1. Junjie Peng MD
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  2. Ye Xu MD
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  3. Zuqing Guan MD
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  4. Ji Zhu MD
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  5. Minghe Wang MD
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  6. Guoxiang Cai MD
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  7. Weiqi Sheng MD
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  8. Sanjun Cai MD
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Corresponding author

Correspondence to Sanjun Cai MD.

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Peng, J., Xu, Y., Guan, Z. et al. Prognostic Significance of the Metastatic Lymph Node Ratio in Node-Positive Rectal Cancer. Ann Surg Oncol 15, 3118–3123 (2008). https://doi.org/10.1245/s10434-008-0123-8

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  • DOI: https://doi.org/10.1245/s10434-008-0123-8

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