Scarinci Andrea, Di Cesare Tatiana, Cavaniglia Daniele, Neri Tiziano, Colletti Michelle, Cosenza Giulia, Liverani Andrea
Department of General Surgery, Regina Apostolorum Hospital, Via San Francesco d'Assisi 50, Albano Laziale, 00041, Rome, Italy.
Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, USA.
Updates Surg. 2018 Mar;70(1):23-31. doi: 10.1007/s13304-018-0519-3. Epub 2018 Mar 2.
Log odds of positive nodes (LODDS), defined as the log of the ratio between the number of positive nodes and the number of negative nodes, has been recently introduced as a tool in predicting prognosis. This study aims to establish the effective and prognostic value of LODDS in predicting the survival outcome of CRC patients undergoing surgical resection. The study population is represented by 323 consecutive patients with primary colon or rectal adenocarcinoma thatunderwent curative resection. LODDS values were calculated by empirical logistic formula, log(pnod + 0.5)/(tnod - pnod + 0.5). It was defined as the log of the ratio between the number of positive nodes and the number of negative nodes. The patients were divided into three groups: LODDS0 (≤ - 1.36), LODDS1 (> - 1.36 ≤ - 0.53) and LODDS2 (> - 0.53). Kaplan-Meier curve analyses showed 3-year OS rates of the patients staged by LODDS classification. These values were 88.3, 74.8 and 61.8% for LODDS0, LODDS1 and LODDS2, respectively (P ≤ 0.001). In a multivariate analysis, LODDS is an independent prognostic factor of 3-year OS. This is in contrast to pN stage and lymph node ratio, which shows no statistical significance. ROC analyses showed that LODDS predicted OS better than lymph node ratio. LODDS classification has a better prognostic effect than pN stage and lymph node ratio. LODDS offers a finer stratification and accurately predicts survival of CRC patients.
阳性淋巴结的对数比值（LODDS）定义为阳性淋巴结数量与阴性淋巴结数量之比的对数，最近被引入作为预测预后的工具。本研究旨在确定LODDS在预测接受手术切除的结直肠癌患者生存结局方面的有效性和预后价值。研究人群为323例连续接受根治性切除的原发性结肠或直肠腺癌患者。LODDS值通过经验逻辑公式log(pnod + 0.5)/(tnod - pnod + 0.5)计算得出。它被定义为阳性淋巴结数量与阴性淋巴结数量之比的对数。患者被分为三组：LODDS0（≤ -1.36）、LODDS1（> -1.36 ≤ -0.53）和LODDS2（> -0.53）。Kaplan-Meier曲线分析显示了按LODDS分类分期的患者的3年总生存率。LODDS0、LODDS1和LODDS2组的这些值分别为88.3%、74.8%和61.8%（P≤0.001）。在多变量分析中，LODDS是3年总生存的独立预后因素。这与pN分期和淋巴结比值相反，后者无统计学意义。ROC分析显示，LODDS预测总生存的效果优于淋巴结比值。LODDS分类比pN分期和淋巴结比值具有更好的预后效果。LODDS提供了更精细的分层，并能准确预测结直肠癌患者的生存情况。
