Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
In Vivo. 2020 May-Jun;34(3):1247-1253. doi: 10.21873/invivo.11898.
BACKGROUND/AIM: To analyze the prognostic significance of nodal status in patients undergoing preoperative chemoradiotherapy (CRT) followed by curative resection for locally advanced rectal cancer. PATIENTS AND METHODS: Between 2000 and 2015, 80 consecutive patients with rectal cancer underwent preoperative CRT followed by curative resection. The lymph node ratio (LNR) was defined as the number of positive lymph nodes (LNs) divided by the examined LNs, and log odds of positive lymph nodes (LODDS) was the log of the ratio between positive and negative LNs. The prognostic value of these indicators was evaluated in terms of overall (OS) and disease-free (DFS) survival. RESULTS: The median follow-up period for patients overall was 59 months (range=11-190 months). The median number of examined LNs and number of positive LNs were 10 (range=1-29) and 2 (range=1-27), respectively, and the median LNR and LODDS values were 0.0 (range=0.0-0.96) and -1.0 (range=-1.7-1.3), respectively. The 5-year OS and DFS were 83% and 64%, respectively. In multivariate analysis, LNR was an independent prognostic factor in terms OS (p=0.041) but not for DFS (p=0.075). LODDS was not significantly associated with OS or DFS. In patients with clinical stage III rectal cancer, LNR was significantly associated with OS and DFS when the number of evaluated LNs was greater than 12 (p=0.038 for OS, p=0.006 for DFS). CONCLUSION: Our study suggests that LNR is a more effective prognostic factor than LODDS in terms of predicting survival. LNR was a significant predictor for survival for patients with clinical stage III rectal cancer with >12 harvested LNs.
背景/目的:分析接受术前放化疗(CRT)后行根治性切除术的局部晚期直肠癌患者的淋巴结状态的预后意义。
患者和方法:2000 年至 2015 年间,80 例直肠癌患者接受了术前 CRT 后行根治性切除术。淋巴结比率(LNR)定义为阳性淋巴结(LNs)的数量除以检查的 LNs,对数阳性淋巴结(LODDS)为阳性 LNs 与阴性 LNs 之间的比值的对数。评估这些指标在总体(OS)和无病(DFS)生存方面的预后价值。
结果:患者的中位随访时间为 59 个月(范围=11-190 个月)。中位检查 LNs 数和阳性 LNs 数分别为 10(范围=1-29)和 2(范围=1-27),中位 LNR 和 LODDS 值分别为 0.0(范围=0.0-0.96)和-1.0(范围=-1.7-1.3)。5 年 OS 和 DFS 分别为 83%和 64%。多变量分析显示,LNR 是 OS 的独立预后因素(p=0.041),但不是 DFS 的独立预后因素(p=0.075)。LODDS 与 OS 或 DFS 无显著相关性。在临床分期为 III 期的直肠癌患者中,当评估的 LNs 数大于 12 时,LNR 与 OS 和 DFS 显著相关(OS:p=0.038,DFS:p=0.006)。
结论:我们的研究表明,LNR 是预测生存的比 LODDS 更有效的预后因素。对于有>12 个阳性 LNs 的临床分期为 III 期的直肠癌患者,LNR 是生存的显著预测因素。
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