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Ratio of Metastatic To Resected Lymph Nodes Enhances To Predict Survival In Patients With Stage III Colorectal Cancer

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

Abstract

Background

The objective of this study was to assess the value of metastatic lymph node ratio in predicting prognosis of patients with stage III colorectal cancer.

Methods

From 2000 to 2005 inclusively, a total of 626 patients featuring stage III colorectal cancer underwent curative resection. These patients were stratified into LNR groups: 1 (0 < LNR ≤ 0.1); 2 (0.1 < LNR ≤ 0.25); 3 (0.25 < LNR ≤ 0.5); and 4 (LNR > 0.5). The follow-up was closed in April 2010. 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

With a median follow-up period of 42.2 months, 5-year overall survival for groups LNR1, LNR2, LNR3, and LNR4 was 73%, 64%, 44%, and 22%, respectively. In the multivariate analysis, the LNR was an independent prognostic factor for survival (P < 0.001). LNR remained statistically significant (P < 0.001), both in patients with colon and rectum cancer regardless of the number of lymph nodes retrieved (≥12 or < 12). The survival rate of ratio group LNR1 was better than ratio group LNR4 (P < 0.001) for patients with the same IIIB or IIIC staging.

Conclusions

LNR is an accurate prognostic method for patients with stage III colorectal cancer. We proposed an algorithm to incorporate LNR into current AJCC staging system to form new staging.

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Acknowledgment

Supported by National Natural Science Foundation (30672408).

Author information

Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China

    Hai-Bo Qiu, Yuan-Fang Li, Zhi-Wei Zhou, Rajiv Prasad Keshari & Rui-Hua Xu

  2. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China

    Hai-Bo Qiu & Rui-Hua Xu

  3. Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China

    Li-Yi Zhang

  4. Department of Gastric & Pancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Hai-Bo Qiu, Yuan-Fang Li, Zhi-Wei Zhou & Rajiv Prasad Keshari

Authors
  1. Hai-Bo Qiu
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  2. Li-Yi Zhang
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  3. Yuan-Fang Li
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  4. Zhi-Wei Zhou
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  5. Rajiv Prasad Keshari
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  6. Rui-Hua Xu
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Corresponding author

Correspondence to Rui-Hua Xu.

Additional information

Hai-Bo Qiu and Li-Yi Zhang contributed equally to this work.

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Qiu, HB., Zhang, LY., Li, YF. et al. Ratio of Metastatic To Resected Lymph Nodes Enhances To Predict Survival In Patients With Stage III Colorectal Cancer. Ann Surg Oncol 18, 1568–1574 (2011). https://doi.org/10.1245/s10434-010-1528-8

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  • DOI: https://doi.org/10.1245/s10434-010-1528-8

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