OBJECTIVETo compare the prognostic value of lymph node ratio and N staging in stage III colorectal cancer.

METHODSThe clinicopathologic factors and follow-up data of 304 cases with stage III colorectal cancer from January 1998 to December 2011 were analyzed retrospectively. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Patients were divided into different subgroups according to the number of lymph nodes sample.

RESULTSLNR and N stage were independent risk factors for stage III colorectal cancer, the prognostic value of LNR was better than that of N stage [Odds ratio were 1.838(95% CI:1.563~2.161) vs. 1.625 (95% CI:1.392~1.898)]. Subgroup analysis showed that, when the number of lymph nodes sample was less than 13, the prognostic value of LNR was better than that of N stage (Odds ratio were 1.836 vs. 1.639). But when the number of lymph nodes sample was more than 13, they were comparable (Odds ratio were 1.876 vs. 1.853).

CONCLUSIONSThe prognostic value of LNR and N stage were comparable for stage III colorectal cancer, but when the number of lymph nodes sample was less than 13, LNR was more valuable.

Colorectal Neoplasms ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies

Purpose: The current meta-analysis combining mid and low rectal cancer with no meta-analysis only for low rectal cancer was seen. This meta-analysis was to compare the short- and mid-term outcomes of the transanal total mesorectal excision (TaTME) vs. laparoscopic total mesorectal excision (LaTME) for low rectal cancer. Methods: A systematic literature search was conducted using the web-based databases; China National Knowledge Infrastructure, Chinese BioMedical Database, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Wanfang Database. Randomized controlled trials (RCTs) were evaluated using the Jadad scale and non-RCTs (NRCs) were evaluated using the Newcastle-Ottawa Scale. Results: Ten studies (2 RCTs and 8 NRCs) involving 772 patients were included. Among them, 378 patients underwent TaTME and 394 patients underwent LaTME. Compared with the LaTME group, the conversion rate was low (risk ratio [RR], 0.25; 95% confidence interval [CI], 0.11–0.54; P < 0.001), the circumferential resection margin (CRM) involvement was low (RR, 0.48; 95% CI, 0.27–0.86; P = 0.010), and the hospital stay was short (mean difference, –1.72; 95% CI, –2.89 to –0.55; P = 0.004) in the TaTME group. No significant differences were seen in the mesorectal resection quality, CRM distance, distal resection margin (DRM) involvement, DRM distance, local R1 resection, intraoperative complications, morbidity, anastomotic leakage, severe morbidity, mortality, operative time, intraoperative blood loss, harvested lymph nodes, and local recurrence rate (P > 0.05). Conclusion The TaTME is a promising surgical technique and is fully a safe and efficacious option in managing low rectal cancer.