Ahmadi Omid, Stringer Mark D, Black Michael A, McCall John L
Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Department of Anatomy, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand.
J Surg Oncol. 2015 Mar 15;111(4):451-8. doi: 10.1002/jso.23848. Epub 2015 Feb 8.
BACKGROUND: Lymph node yield (LNY) and lymph node ratio (LNR) are recognized as independent prognostic factors in colorectal cancer (CRC). OBJECTIVES: To examine the relationship between LNY and other clinico-pathological variables, and the prognostic value of LNY and LNR on patient survival in CRC. METHODS: The clinico-pathological and survival data for patients diagnosed from January 2000 to July 2012 were retrieved from the New Zealand Cancer Registry. Multiple linear regression was used to identify clinico-pathological factors influencing LNY, and Cox regression was used to determine the association between LNY and LNR and patient survival. RESULTS: 14,646 patients were included in the study (mean age 70.3 years, 50.1% male). Mean LNY was 17.4. Younger age, right-sided disease, higher T stage, female sex and no neoadjuvant radiotherapy (rectal cancer) were all associated with higher LNY (P ≤ 0.001). Overall survival in Stage I-III disease increased with higher LNY (for LNY ≥ 12, HR = 0.67, 95% CI 0.64-0.72; P < 0.001). Survival in Stage III-IV disease was inversely related to LNR (HR = 0.56, 95% CI 0.51-0.62; P < 0.001). CONCLUSION: LNY is influenced by patient age, site of disease and T stage. LNY (Stage I-II) and LNR (Stage III-IV) have independent prognostic value in CRC.
背景:淋巴结收获量(LNY)和淋巴结比率(LNR)被认为是结直肠癌(CRC)的独立预后因素。 目的:研究LNY与其他临床病理变量之间的关系,以及LNY和LNR对CRC患者生存的预后价值。 方法:从新西兰癌症登记处检索2000年1月至2012年7月诊断患者的临床病理和生存数据。采用多元线性回归确定影响LNY的临床病理因素,采用Cox回归确定LNY和LNR与患者生存之间的关联。 结果:14646例患者纳入研究(平均年龄70.3岁,50.1%为男性)。平均LNY为17.4。年龄较小、右侧疾病、较高的T分期、女性以及未接受新辅助放疗(直肠癌)均与较高的LNY相关(P≤0.001)。I-III期疾病的总生存率随LNY升高而增加(LNY≥12时,HR=0.67,95%CI 0.64-0.72;P<0.001)。III-IV期疾病的生存率与LNR呈负相关(HR=0.56,95%CI 0.51-0.62;P<0.001)。 结论:LNY受患者年龄、疾病部位和T分期影响。LNY(I-II期)和LNR(III-IV期)在CRC中具有独立的预后价值。
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