Deng Yuxiang, Peng Jianhong, Zhao Yujie, Sui Qiaoqi, Zhao Ruixia, Lu Zhenhai, Qiu Miaozhen, Lin Junzhong, Pan Zhizhong
Department of Colorectal Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China,
Department of Public Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
Cancer Manag Res. 2018 Jul 17;10:2083-2094. doi: 10.2147/CMAR.S169029. eCollection 2018.
Recent studies have suggested that the lymph node ratio (LNR) is a prognostic indicator for various malignancies. However, LNR has not been evaluated in colorectal liver-only metastasis (CRLM). This study aimed to investigate the prognostic value of LNR in patients with CRLM after curative resection.
We retrospectively investigated the clinicopathologic features of 154 CRLM patients who underwent curative resection between 2005 and 2015. We classified patients into low and high groups based on their LNR by using the X-tile software. Survival curves were plotted through Kaplan-Meier method and compared by log-rank test. Cox proportional hazards analysis was performed to identify the factors associated with recurrence-free survival (RFS) and overall survival (OS).
The patients were divided into two groups in which 124 patients were identified as LNR ≤0.33 and 30 patients as LNR >0.33. Compared to low LNR, high LNR was significantly associated with poor 3-year RFS (47.2% vs 16.7%, =0.001) and OS (72.8% vs 45.3%, =0.003) rates. Multivariate analysis indicated that the LNR was an independent predictor for 3-year RFS (hazard ratio, 2.124; 95% CI, 1.339-3.368; =0.001) and OS (HR, 2.287; 95% CI, 1.282-4.079; =0.005). However, the node (N) stage and lymph node distribution were not significantly associated with the 3-year RFS (=0.071, =0.226) or OS (=0.452, =0.791) in patients with CRLM.
This study demonstrated that LNR was an independent predictor for 3-year RFS and OS in patients with CRLM who underwent curative resection and that its prognostic value was superior to that of N stage and lymph node distribution.
近期研究表明，淋巴结比率（LNR）是多种恶性肿瘤的预后指标。然而，LNR尚未在单纯性结直肠癌肝转移（CRLM）中得到评估。本研究旨在探讨LNR在CRLM患者根治性切除术后的预后价值。
我们回顾性研究了2005年至2015年间接受根治性切除的154例CRLM患者的临床病理特征。我们使用X-tile软件根据LNR将患者分为低LNR组和高LNR组。通过Kaplan-Meier方法绘制生存曲线，并通过对数秩检验进行比较。进行Cox比例风险分析以确定与无复发生存期（RFS）和总生存期（OS）相关的因素。
患者被分为两组，其中124例患者的LNR≤0.33，30例患者的LNR>0.33。与低LNR相比，高LNR与3年RFS率（47.2%对16.7%，P = 0.001）和OS率（72.8%对45.3%，P = 0.003）显著相关。多因素分析表明，LNR是3年RFS（风险比，2.124；95%置信区间，1.339 - 3.368；P = 0.001）和OS（HR，2.287；95%置信区间，1.282 - 4.079；P = 0.005）的独立预测因素。然而，在CRLM患者中，淋巴结（N）分期和淋巴结分布与3年RFS（P = 0.071，P = 0.226）或OS（P = 0.452，P = 0.791）无显著相关性。
本研究表明，LNR是接受根治性切除的CRLM患者3年RFS和OS的独立预测因素，其预后价值优于N分期和淋巴结分布。
