Aslan Orhan, Topcu Ramazan, Sezikli İsmail, Yüksek Mahmut A, Perçem Aşkın K, Uğur Furkan
Department of General Surgery, Faculty of Medicine, Hitit University, Çorum, Türkiye.
Department of Gastroenterology Surgery, Hitit University Erol Olçok Training and Research Hospital, Çorum, Türkiye.
Front Oncol. 2025 Aug 27;15:1624798. doi: 10.3389/fonc.2025.1624798. eCollection 2025.
The metastatic lymph node ratio (MLNR) has been proposed as a meaningful prognostic indicator in colon cancer (CC). This study aimed to assess the prognostic relevance of MLNR by investigating its association with disease-free survival (DFS), overall survival (OS), and recurrence, and to compare its predictive value with traditional parameters, including the TNM classification and total lymph node count (TNLC).
This retrospective, single-center study included patients who underwent surgical resection for colon cancer. Survival outcomes were analyzed using Kaplan-Meier survival curves and multivariate logistic regression. MLNR was evaluated in relation to demographic and clinical factors, including age, tumor location, surgical type, and the administration of adjuvant chemotherapy. The optimal MLNR cut-off value for predicting recurrence was determined via receiver operating characteristic (ROC) curve analysis.
A total of 122 patients were analyzed. MLNR >0.125 was significantly associated with increased recurrence risk (adjusted HR: 7.0, p<0.001) and reduced DFS. Patients with an MLNR ≤0.125 demonstrated significantly longer DFS (p<0.001). MLNR emerged as an independent prognostic factor, offering potential prognostic benefit compared to TNLC in predicting both DFS and OS. Additionally, adjuvant chemotherapy was independently associated with a lower recurrence risk (Exp(B):0.234, p=0.038). Emergency surgery was found to be significantly correlated with poorer survival outcomes (p=0.023).
MLNR contributes additional prognostic information to the TNM staging system and may support more individualized risk stratification and decision-making regarding adjuvant therapy in colon cancer. Further large-scale prospective studies are warranted to validate these findings and to establish a clinically applicable MLNR threshold.
转移淋巴结比率（MLNR）已被提出作为结肠癌（CC）中有意义的预后指标。本研究旨在通过调查MLNR与无病生存期（DFS）、总生存期（OS）和复发的关联来评估其预后相关性，并将其预测价值与传统参数（包括TNM分类和总淋巴结计数（TNLC））进行比较。
这项回顾性单中心研究纳入了接受结肠癌手术切除的患者。使用Kaplan-Meier生存曲线和多因素逻辑回归分析生存结果。评估了MLNR与人口统计学和临床因素（包括年龄、肿瘤位置、手术类型和辅助化疗的使用）的关系。通过受试者工作特征（ROC）曲线分析确定预测复发的最佳MLNR临界值。
共分析了122例患者。MLNR>0.125与复发风险增加（调整后HR：7.0，p<0.001）和DFS降低显著相关。MLNR≤0.125的患者DFS显著更长（p<0.001）。MLNR成为独立的预后因素，在预测DFS和OS方面比TNLC具有潜在的预后优势。此外，辅助化疗与较低的复发风险独立相关（Exp(B)：0.234，p=0.038）。发现急诊手术与较差的生存结果显著相关（p=0.023）。
MLNR为TNM分期系统提供了额外的预后信息，并可能支持结肠癌辅助治疗中更个体化的风险分层和决策。有必要进行进一步的大规模前瞻性研究以验证这些发现并建立临床适用的MLNR阈值。
