OBJECTIVETo assess the prognostic value of lymph node ratio (LNR) in patients with stage III rectal cancer after curative resection.

METHODSA retrospective review of the clinicopathological data was performed in 161 patients with stage III rectal cancer who received curative surgical excision in our hospital from June 2005 to June 2010. The variables including LNR, age, gender, T stage, N stage, total number of dissected lymph nodes, number of metastatic lymph nodes, and positive rate of lymph node metastasis were studied through univariate and multivariate analyses, and the survival analysis was performed using Kaplan-Meier method and Log rank test.

RESULTSMultivariate analysis revealed that LNR, but not number of positive nodes or number of harvested lymph nodes, had independent prognostic value for overall survival and disease-free survival for patients with stage III rectal cancer. The overall survival in the LNR < 0.43 and LNR ≥ 0.43 groups was 75.8% and 41.3%, respectively (P < 0.01), while the disease-free survival was 68.8% and 40.3%, respectively (P = 0.001).

CONCLUSIONSThe LNR is an independent prognostic factor for survival of patients with stage III rectal cancer, and is more efficient than the number of positive nodes and total number of dissected lymph nodes in the survival prediction.