Fidan Evren, Merev Elif, Usta Arif, Alandag Celal, Disli Safak, Ozdover Ali
Dr. Evren Fidan, MD, Associate Professor Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Dr. Elif Merev, MD, Specialist, Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Pak J Med Sci. 2022 Mar-Apr;38(3Part-I):605-611. doi: 10.12669/pjms.38.3.5085.
To investigate the prognostic significant of lymph node ratio and surgical margins in patients with colon cancer undergoing surgery.
This observational and retrospective study was conducted at Karadeniz Technical University Medical Faculty, between 1 January, 2010 and 31 November, 2020. A series of 137 patients who had undergone surgical resection of colon carcinoma were included in this study. mLNR, defined as the ratio of the number of mLNs to the number of examined lymph nodes, was calculated in colorectal cancer cases with lymph node metastasis. Patients were divided into three groups; LNR1 (< 0.25), LNR2 (0.25-0.6) and LNR3 (> 0.6).
Mean disease-free survival was 79.2 months (95% CI 71.0-87.4). The mean expected survival time was 73.5 months (95% CI: 65.9-81.0). As the metastatic LN ratio increased, the rate of local recurrence or distant metastasis increased statistically significantly (p=0.007). As the metastatic LN ratio increased, the death rate increased statistically significantly (p=0.036). Metastatic lymph node ratio did not have a statistically significant effect on overall survival in patients with stage-3 and more than 12 LNs removed (p=0.069). There was no statistically significant association between the closeness of the surgical margin and disease-free survival in stage 1 (p=0.505) and stage-2 (p=0.161). There was no statistically significant association between the closeness of the surgical margin and overall survival among patients with stage 1 (p=0.494) and stage 2 (p=0.265).
A high metastatic LNR is associated with poorer overall and disease-free survival.
探讨接受手术治疗的结肠癌患者淋巴结比率及手术切缘的预后意义。
本观察性回顾性研究于2010年1月1日至2020年11月31日在黑海技术大学医学院进行。本研究纳入了137例行结肠癌手术切除的患者。在发生淋巴结转移的结直肠癌病例中计算mLNR，即转移淋巴结数量与检查淋巴结数量之比。患者分为三组：LNR1（<0.25）、LNR2（0.25 - 0.6）和LNR3（>0.6）。
平均无病生存期为79.2个月（95%CI 71.0 - 87.4）。平均预期生存时间为73.5个月（95%CI：65.9 - 81.0）。随着转移淋巴结比率增加，局部复发或远处转移发生率有统计学显著增加（p = 0.007）。随着转移淋巴结比率增加，死亡率有统计学显著增加（p = 0.036）。转移淋巴结比率对3期且切除淋巴结超过12枚的患者的总生存期无统计学显著影响（p = 0.069）。在1期（p = 0.505）和2期（p = 0.161）患者中，手术切缘的接近程度与无病生存期之间无统计学显著关联。在1期（p = 0.494）和2期（p = 0.265）患者中，手术切缘的接近程度与总生存期之间无统计学显著关联。
高转移LNR与较差的总生存期和无病生存期相关。
