Petrucciani Niccolò, Carra Maria Clotilde, Martínez-Pérez Aleix, Vitali Giulio Cesare, Landi Filippo, Genova Pietro, Memeo Riccardo, Brunetti Francesco, Espin Eloy, Ris Frederic, De'angelis Nicola
Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.
Rothschild Hospital, AP-HP, Paris VII University, Paris, France.
Anticancer Res. 2019 Apr;39(4):2113-2120. doi: 10.21873/anticanres.13324.
BACKGROUND/AIM: The aim of this study was to compare the ability of different lymph nodal staging systems to predict cancer recurrence in a multicenter European series of patients who underwent proctectomy after neoadjuvant chemoradiotherapy for locally advanced rectal cancer. PATIENTS AND METHODS: Data on 170 consecutive patients undergoing proctectomy after neoadjuvant therapy for cT3-4 or cN+ rectal adenocarcinoma were retrieved from the European MRI and Rectal Cancer Surgery database. The prognostic role of the number of retrieved and examined nodes, nodal ratio, and log odds of positive lymph nodes (LODDS) was analyzed and compared by receiver operating characteristic curves, Pearson test, and univariate and multivariate analysis. RESULTS: At multivariate analysis, ypN, nodal ratio, and LODDS were all significantly associated with disease-free survival, but LODDS showed the strongest association (hazard ratio(HR)=2.39; 95% confidence interval(CI)=1.05-5.48; p=0.039). CONCLUSION: LODDS appears to be a useful prognostic indicator in the prediction of disease-free survival of patients undergoing neoadjuvant chemoradiotherapy and proctectomy for locally advanced rectal cancer.
背景/目的:本研究旨在比较不同淋巴结分期系统对欧洲多中心系列局部晚期直肠癌患者新辅助放化疗后行直肠切除术预测癌症复发的能力。 患者与方法:从欧洲MRI与直肠癌手术数据库中检索170例接受新辅助治疗的cT3-4或cN+直肠腺癌患者行直肠切除术的数据。通过受试者工作特征曲线、Pearson检验以及单因素和多因素分析,对获取和检查的淋巴结数量、淋巴结比率以及阳性淋巴结对数优势比(LODDS)的预后作用进行分析和比较。 结果:多因素分析显示,ypN、淋巴结比率和LODDS均与无病生存期显著相关,但LODDS显示出最强的相关性(风险比(HR)=2.39;95%置信区间(CI)=1.05-5.48;p=0.039)。 结论:对于接受新辅助放化疗和直肠切除术的局部晚期直肠癌患者,LODDS似乎是预测无病生存期的有用预后指标。
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