Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
J Surg Oncol. 2011 Apr;103(5):406-10. doi: 10.1002/jso.21830. Epub 2010 Dec 22.
The aim of this study was to evaluate the prognostic usefulness of the lymph node ratio (LNR) in stage III colon cancer using the 7th edition of the American Joint Committee on Cancer (AJCC) staging system.
We analyzed data from 130 consecutive patients with stage III colon cancer. Kaplan-Meier and Cox proportional hazard model analyses were used to evaluate prognostic effects.
Quartile analysis indicated that an LNR of 0.1638 was the best cut-off value with regard to predicting disease-free survival (DFS). Six patients had stage IIIA disease, 102 patients had stage IIIB disease, and 22 patients had stage IIIC disease. For patients with stage IIIB disease, the 3-year DFS for an LNR of <0.1638 (N = 87) and an LNR of ≥0.1638 (N = 15) was 79.0% and 50.0%, respectively (P = 0.015). For patients with stage IIIC disease, the 3-year DFS for an LNR of <0.1638 (N = 6) and an LNR of ≥0.1638 (N = 16) was 100% and 28.6%, respectively (P = 0.03).
The authors found that 7th AJCC stage IIIB and stage IIIC patients are heterogeneous groups with respect to DFS, when stratified by LNR, and suggest that an LNR-based algorithm be devised for incorporation into the 7th AJCC staging system.
本研究旨在使用第 7 版美国癌症联合委员会（AJCC）分期系统评估淋巴结比率（LNR）在 III 期结肠癌中的预后作用。
我们分析了 130 例连续 III 期结肠癌患者的数据。采用 Kaplan-Meier 和 Cox 比例风险模型分析评估预后效果。
四分位分析表明，LNR 为 0.1638 时预测无病生存（DFS）的最佳截断值。6 例患者为 IIIA 期，102 例患者为 IIIB 期，22 例患者为 IIIC 期。对于 IIIB 期患者，LNR<0.1638（N=87）和 LNR≥0.1638（N=15）的 3 年 DFS 分别为 79.0%和 50.0%（P=0.015）。对于 IIIC 期患者，LNR<0.1638（N=6）和 LNR≥0.1638（N=16）的 3 年 DFS 分别为 100%和 28.6%（P=0.03）。
作者发现，按 LNR 分层时，第 7 版 AJCC IIIB 期和 IIIC 期患者在 DFS 方面是异质的，建议设计一种基于 LNR 的算法纳入第 7 版 AJCC 分期系统。
