Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey.
Department of Pathology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey.
Acta Chir Belg. 2023 Oct;123(5):535-543. doi: 10.1080/00015458.2022.2103247. Epub 2022 Jul 25.
The lymph node ratio (LNR), defined as the number of positive lymph nodes (LN) divided by the total number of harvested LN, has been demonstrated to be an independent factor in the prognosis of surgically treated colorectal cancer (CRC) patients. This study aims to establish the prognostic value of LNR in stage III CRC patients with high numbers of LN removed.
Stage III CRC patients who underwent curative resections over an 8-year period were included to the study. Demographics, clinicopathological features, surgical as well as recurrence and survival outcomes were recorded and statistically analyzed. Calculations for LNR were carried out as a function of percentage rates and Cox proportional hazards regression analyses were performed to determine its effect on disease-free and overall survival.
Among a total of 493 surgically treated CRC cases, 104 patients were included to the study consisting of 68 (65.4%) men and 36 (34.6%) women with a median age of 64 (inter-quartile range: 55-74) years. The mean number of harvested LN was 31.6 ± 21.0 (range: 12-103). Multivariate Cox regression analyses proved LNR to be a significant factor in both disease-free and overall survival ( = 0.007 and = 0.003, respectively). Forward elimination analyses showed that a 1% increase in LNR resulted with a 2% increase in both the risks of recurrence and mortality.
The LNR may be assessed as an adjunct to the current staging systems for the prediction of oncological outcomes and survival of surgically treated stage III CRC patients.
淋巴结比率（LNR）定义为阳性淋巴结（LN）的数量除以收获的 LN 总数，已被证明是手术治疗结直肠癌（CRC）患者预后的独立因素。本研究旨在建立在移除 LN 数量较高的 III 期 CRC 患者中 LNR 的预后价值。
本研究纳入了 8 年内接受根治性切除术的 III 期 CRC 患者。记录人口统计学、临床病理特征、手术以及复发和生存结果，并进行了统计学分析。LNR 的计算作为百分比的函数进行，Cox 比例风险回归分析用于确定其对无病和总生存的影响。
在总共 493 例接受手术治疗的 CRC 病例中，共有 104 例患者被纳入研究，其中 68 例（65.4%）为男性，36 例（34.6%）为女性，中位年龄为 64 岁（四分位间距：55-74）。收获的 LN 平均数量为 31.6±21.0（范围：12-103）。多变量 Cox 回归分析证明 LNR 在无病和总生存方面均为显著因素（=0.007 和=0.003）。向前消除分析表明，LNR 增加 1%，复发和死亡的风险分别增加 2%。
LNR 可作为当前分期系统的辅助手段，用于预测手术治疗的 III 期 CRC 患者的肿瘤学结局和生存。
