Novel lymph node ratio predicts prognosis of colorectal cancer patients after radical surgery when tumor deposits are counted as positive lymph nodes: a retrospective multicenter study.
The lymph node ratio (LNR), defined as the relation of tumor-infiltrated to resected lymph nodes, has been identified as an independent prognostic factor for colorectal cancer (CRC) after radical surgery. Recently, new guidelines propose counting tumor deposits (TDs) as positive lymph nodes (pLNs). The aim of this study was to investigate whether a novel LNR (nLNR) that considers TDs as pLNs can be used to accurately predict the long-term outcome of CRC patients. In this multicenter retrospective study, clinicopathological and outcome data from 2,051 stage III CRC patients who underwent R0 resection were collected between January 2004 and December 2011. Disease-free survival (DFS) and overall survival (OS) according to the nLNR category were analyzed using Kaplan-Meier survival curves. Univariate and multivariate analyses were performed to determine significant prognostic factors, and ROC curves were computed to measure the predictive capacity of the nLNR category. The 5-year DFS rates of nLNR1-4 were 68.3%, 48.4%, 33.3% and 16.5%, respectively (P<0.0001), and the 5-year OS rate of nLNR1-4 were 71.8%, 60.1%, 42.7% and 21.8%, respectively (P<0.0001). The area of under curve (AUC) of the nLNR was 0.686 (95% CI 0.663-0.710) and 0.672 (95% CI 0.648-0.697) for predicting DFS and OS. Our results demonstrate that the nLNR predicted long-term outcomes better than the LNR, npN and pN, using the cutoff points 0.250, 0.500 and 0.750.
['Yang|Jin|J|', 'Xing|Shasha|S|', 'Li|Jun|J|', 'Yang|Shengke|S|', 'Hu|Junjie|J|', 'Liu|Hao|H|', 'Du|Feng|F|', 'Yin|Jie|J|', 'Liu|Sai|S|', 'Li|Ci|C|', 'Yuan|Jiatian|J|', 'Lv|Bo|B|']
D000328:Adult D000368:Aged D015179:Colorectal Neoplasms D003131:Combined Modality Therapy D005260:Female D005500:Follow-Up Studies D006801:Humans D008198:Lymph Nodes D008207:Lymphatic Metastasis D008297:Male D008875:Middle Aged D011379:Prognosis D012372:ROC Curve D012189:Retrospective Studies D016019:Survival Analysis D016896:Treatment Outcome
lymph node ratio prognosis colorectal cancer tumor deposits