Prognostic Significance of Lymph Node Ratio in Stage III Rectal Cancer.
10.3393/jksc.2011.27.5.252
- Author:
Jin Yong SHIN
1
;
Kwan Hee HONG
Author Information
1. Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Rectal cancer;
Lymph node;
Prognosis
- MeSH:
Humans;
Lymph Nodes;
Neoplasm Metastasis;
Neoplasm Staging;
Population Characteristics;
Prognosis;
Rectal Neoplasms;
Recurrence;
Risk Factors
- From:Journal of the Korean Society of Coloproctology
2011;27(5):252-259
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Although nodal metastasis is the most powerful prognostic factor in rectal cancer, marked heterogeneity exists within stage III rectal cancer. Recent studies of rectal cancer have shown a prognostic superiority of the lymph node ratio (LNR) compared with N stage. The purpose of this study was to investigate the prognostic value of the LNR in the era of the 7th edition of the TNM classification. METHODS: We included 190 patients who underwent a curative resection for rectal cancer with nodal metastasis. The patients were divided into four groups on the basis of statistically calculated cut-off values as 0.21, 0.32, and 0.61. RESULTS: The LNR was an independent risk factor for overall survival (OS; P = 0.008) and for systemic recurrence-free survival (SRFS; P = 0.002). However, the LNR was not a predictive factor for local recurrence. When the N stage of the sixth TNM staging system was separately analyzed as a covariate, the LNR was also found to be a predictive factor for both OS and SRFS (P = 0.012 and P = 0.004, respectively). A LNR value of 0.21 offered the best cut off to separate patients into two prognostic groups. CONCLUSION: The defined cut-off values of the LNR were an independent risk factor for OS and distant metastasis-free survival in patients with rectal cancer, irrespective of the sixth or the seventh version of the TNM classification, and the LNR should be considered as a prognostic variable in any future staging system.
