Prognosis Impact of the Lymph Node Ratio in Patients with Colon Adenocarcinoma: a Single-Centre Experience

Ramos-Esquivel, Allan; Juárez, Melissa; Gonzalez, I; Juan, P Palazzo; Rodrı́guez, Luis A. Garcı́a

doi:10.1007/s12029-013-9576-5

Cited by 9 publications

(9 citation statements)

References 13 publications

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“…However, dichotomous data may be more advantageous than continuous data for the application of mLNR. Previous studies used various criteria for high mLNR, from 0.125 to 0.3 [4,17,19,20,21,22,23,28,29,30,31,32,33,34]. In the present study, the prognostic impacts of high mLNR were investigated using various cutoffs (from 0.1 to 0.4).…”

Section: Discussionmentioning

confidence: 96%

“…In our results, there was a significant correlation between high mLNRs and worse survival in CRC. As the prognostic implications of mLNR are controversial between studies, detailed analyses are needed to examine mLNRs in CRC [17,18,19,20,21,22,23,27,28,29,30,31,32,33].…”

Section: Discussionmentioning

confidence: 99%

“…Berger et al first reported the prognostic role of mLNR in CRC [16], though no detailed information regarding the criteria for high mLNR is currently available. Recently, the mLNR has been explored as a prognostic factor on survival outcomes and time to progression for patients with colon cancer [17,18,19,20,21,22,23,24,25,26].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location

Pyo

Shin

Kang

2019

JCM

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Background: The proportion of the number of involved lymph nodes (LNs) to the number of examined LNs—defined as metastatic LN ratio (mLNR)—has been considered as a prognostic parameter. This study aims to elucidate the prognostic implication of the mLNR in colorectal cancer (CRC) according to the tumor location. Methods: We evaluated the correlation between prognoses and the involved and examined LNs as well as mLNR according to the tumor location in 266 surgically resected human CRCs. Besides, to evaluate the optimal cutoff for high and low mLNRs, we investigated the correlation between mLNR and survival according to the various cutoffs. Results: LN metastasis was found in 146 cases (54.9%), and colon and rectal cancers were found in 116 (79.5%) and 30 (20.5%) of the cases, respectively. The mean mLNRs were significantly higher in rectal cancer than in colon cancer (0.38 ± 0.28 vs. 0.21 ± 0.24, P = 0.003). Besides this, the number of involved LNs in rectal cancer was significantly high compared to colon cancer (11.83 ± 10.92 vs. 6.37 ± 7.78, P = 0.014). However, there was no significant difference in the examined LNs between the rectal and colon cancers (31.90 ± 12.28 vs. 36.60 ± 18.11, P = 0.181). In colon cancer, a high mLNR was significantly correlated with worse survival for all cutoffs (0.1, 0.2, 0.3, and 0.4). However, rectal cancer only showed a significant correlation between high mLNR and worse survival in the subgroup with a cutoff of 0.2. Conclusions: Our results showed that high mLNR was significantly correlated with worse survival. The number of involved LNs and mLNRs were significantly higher in rectal cancer than in colon cancer. The cutoff of 0.2 can be useful for the differentiation of prognostic groups, regardless of tumor location.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location

Pyo

Shin

Kang

2019

JCM

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“…Eligible studies of the present meta-analysis with criteria for high mLNR were ranged from 0.125 to 0.3. The criteria for high mLNR in eligible studies were defined by independent guidelines [7,8,9,10,11,12,13,14,15,16,17,18,19,20]. Also, each study included CRCs with various tumor stages and population.…”

Section: Discussionmentioning

confidence: 99%

“…Two independent authors extracted data from all eligible studies. The selected data were obtained from each of the eligible studies [7,8,9,10,11,12,13,14,15,16,17,18,19,20]: We collected the author’s first name, the publication year of articles, the location of the research, number of patients analyzed, and the correlation between high mLNR and survival rates. The correlation between high mLNR and survival outcomes was evaluated according to the hazard ratio (HR) for the quantitative aggregation of survival results.…”

Section: Methodsmentioning

confidence: 99%

Metastatic Lymph Node Ratio (mLNR) is a Useful Parameter in the Prognosis of Colorectal Cancer; A Meta-Analysis for the Prognostic Role of mLNR

et al. 2019

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Background and objectives: The presenting study aimed to elucidate the prognostic role of the metastatic lymph node ratio (mLNR) in patients with colorectal cancer (CRC), using a meta-analysis. Materials and Methods: Using data from 90,274 patients from 14 eligible studies, we performed a meta-analysis for the correlation between mLNR and survival rate. Besides, subgroup analyses were performed, based on tumor stage, tumor location, and mLNR. Results: A high mLNR showed significant correlation with worse overall survival and disease-free survival rates in CRC patients (hazard ratio (HR), 1.617, 95% confidence interval (CI) 1.393–1.877, and HR 2.345, 95% CI 1.879–2.926, respectively). In patients with stage III, who had regional LN metastasis, the HRs were 1.730 (95% CI 1.266–2.362) and 2.451 (95% CI 1.719–3.494) for overall and disease-free survival, respectively. According to tumor location, rectal cancer showed a worse survival rate when compared to colon cancer. In the analysis for overall survival, when mLNR was 0.2, HR was the highest across the different subgroups (HR 5.040, 95% CI 1.780–14.270). However, in the analysis for disease-free survival, the subgroup with an mLNR < 0.2 had a higher HR than the other subgroups (HR 2.878, 95% CI 1.401–5.912). Conclusions: The mLNR may be a useful prognostic factor for patients with CRC, regardless of the tumor stage or tumor location. Further studies are necessary for the detailed criteria of mLNR before its application in daily practice.

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Log odds of positive lymph nodes is a superior prognostic indicator in stage III rectal cancer patients: A retrospective analysis of 17,632 patients in the SEER database

Huang

Chen

et al. 2016

International Journal of Surgery

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Prognosis Impact of the Lymph Node Ratio in Patients with Colon Adenocarcinoma: a Single-Centre Experience

Abstract: LNR was independently associated with OS and DFS in patients with colon adenocarcinoma regardless of its clinical stage.

Cited by 9 publications

References 13 publications

Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location

Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location

Metastatic Lymph Node Ratio (mLNR) is a Useful Parameter in the Prognosis of Colorectal Cancer; A Meta-Analysis for the Prognostic Role of mLNR

Log odds of positive lymph nodes is a superior prognostic indicator in stage III rectal cancer patients: A retrospective analysis of 17,632 patients in the SEER database

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