The Prognostic Value of Lymph Node Ratio After Neoadjuvant Chemoradiation and Rectal Cancer Surgery

Klos, Coen L.; Bordeianou, Liliana; Sylla, Patricia; Chang, Yung-Fu; Berger, David L.

doi:10.1007/dcr.0b013e3181fd677d

Cited by 34 publications

(21 citation statements)

References 21 publications

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“…Because this study was not prospectively designed, it is subject to potential bias. The cutoff value of LNR is different from other studies (Kang et al, 2011;Klos et al, 2011;La et al, 2013;Madbouly et al, 2013;Nadoshan et al, 2013). In fact, the cutoff value varies among different studies, ranged from 0.07 to 0.6 (Madbouly et al, 2013).…”

Section: Discussionmentioning

confidence: 60%

Lymph Node Ratio is an Independent Prognostic Factor in Node Positive Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy Followed by Curative Resection

Zeng

Zhou²,

Wang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The lymph node ratio (LNR) has been shown to be an important prognostic factor for colorectal cancer. However, studies focusing on the prognostic impact of LNR in rectal cancer patients who received neoadjuvant chemoradiotherapy (CRT) followed by curative resection have been limited. The aim of this study was to investigate LNR in rectal cancer patients who received neoadjuvant chemoradiotherapy harvested LNs, and as well as in those ≥12 harvested LNs (p<0.05). In addition, LNR had a prognostic impact on both OS and DFS in patients with N1 staging (p<0.001). Conclusions: LNR is an independent prognostic factor in ypN-positive rectal cancer patients, both in patients with <12 harvested LNs, and as well as in those ≥12 harvested LNs. LNR provides better prognostic value than pN staging. Therefore, it should be used as an additional prognostic indicator in ypN-positive rectal cancer patients.

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Section: Discussionmentioning

confidence: 60%

Lymph Node Ratio is an Independent Prognostic Factor in Node Positive Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy Followed by Curative Resection

Zeng

Zhou²,

Wang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…The remaining 21 studies were reviewed with full texts, among which two studies had unclear reporting of neoadjuvant therapy, one lacked endpoint data, and five lacked comparison between LNR groups. Finally, 13 studies with 4023 participants were included in the meta‐analysis, and all were published in recent years (from 2011 up to now). Table offers the baseline characteristics of all included studies.…”

Section: Resultsmentioning

confidence: 99%

“…OS, as the primary outcome, was extracted from 11 studies with available data. Among them, eight studies reported high and low LNRs with one cut‐off value, and a pooled HR of 2.94 (95% CI:1.97 to 3.91, P < 0.001) demonstrated that a high LNR is a predictor of poor OS in rectal cancer after neoadjuvant therapy (Figure ).…”

Section: Resultsmentioning

confidence: 99%

Lymph node ratio is an independent prognostic factor for rectal cancer after neoadjuvant therapy: A meta‐analysis

Jin

Deng

et al. 2018

J Evidence Based Medicine

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“…[4][5][6][7][8] Peng and colleagues 8 were the first to demonstrate the association between LNR and survival rate in patients with rectal cancer. The mean LNR was 0.34, and they reported that LNR was an independent risk factor for local recurrence, DFS and OS.…”

mentioning

confidence: 99%

“…The mean LNR was 0.34, and they reported that LNR was an independent risk factor for local recurrence, DFS and OS. In these studies, [4][5][6][7][8] 9 According to the seventh edition of the TNM classification, patients with stage III cancer are classified based on the number of positive nodes. Intuitively, it seems safe to believe that the prognostic significance of 5 positive nodes out of a total of 5 will be completely different from 5 positive nodes out of a total of 30.…”

mentioning

confidence: 99%

Prognostic value of lymph node ratio in survival of patients with locally advanced rectal cancer

Zhou

Bai

et al. 2015

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Background:The lymph node ratio (LNR) has been shown to be an important prognostic factor in patients with gastric, breast, pancreatic and colorectal cancer. We investigated the prognostic impact of the LNR in addition to TNM classification in patients with locally advanced rectal cancer. Methods:We retrospectively analyzed patients who underwent curative resection for locally advanced rectal cancer between July 2005 and December 2010. We determined the LNR cutoff value using a receiver operating characteristic curve. The Kaplan-Meier method was used to estimate survival curves, while Cox regression analyses were used to evaluate the relationship between LNR and survival. Results:We included 180 patients aged 28-83 years with median follow-up of 41.8 months. The median number of lymph nodes examined and lymph nodes involved were 11.5 and 4, respectively, and the median LNR was 0.366. An LNR of 0.19 (19%) was the cutoff point to separate patients with regard to median overall survival. Median overall survival was 64.2 months for patients with an LNR of 0, 59.1 for an LNR of 0.19 or less and 37.6 for an LNR greater than 0.19 (p = 0.004). The median disease-free survival was 32.9 months for patients with an LNR of 0, 30.4 for an LNR of 0.19 or less and 17.8 for an LNR greater than 0.19 (p = 0.002). Conclusion:Our results suggest that LNR should be considered an additional prognostic factor in patients with locally advanced rectal cancer.Contexte : Il a été démontré que le ratio de ganglions lymphatiques positifs est un important facteur pronostique chez les patients atteints de cancer de l'estomac, de cancer du sein, de cancer du pancréas et de cancer colorectal. Nous avons étudié l'incidence pronostique de l'utilisation de ce ratio en plus de la classification TNM chez les patients présentant un cancer du rectum localement avancé.Méthodes : Nous avons analysé rétrospectivement des patients ayant subi une résec-tion curative visant à traiter un cancer du rectum localement avancé entre juillet 2005 et décembre 2010. Nous avons déterminé la valeur seuil du ratio de ganglions lymphatiques positifs à l'aide d'une courbe caractéristique de la performance. La méthode de Kaplan-Meyer a été utilisée pour estimer les courbes de survie, tandis que le modèle de régression des hasards proportionnels de Cox a servi à évaluer la corréla-tion entre le ratio à l'étude et la survie.Résultats : Notre étude a porté sur 180 patients de 28 à 83 ans dont la durée mé diane du suivi était de 41,8 mois. Les nombres médians de ganglions lymphatiques examinés et de ganglions lymphatiques positifs étaient de 11,5 et 4, respectivement, et le ratio médian de ganglions lymphatiques positifs était de 0,366. Nous avons utilisé une valeur seuil de 0,19 (19 %) pour séparer les patients en ce qui a trait à la survie globale médiane. Cette mesure était de 64,2 mois pour les patients présentant un ratio de 0, de 59,1 mois pour ceux présentant un ratio de 0,19 ou moins, et de 37,6 mois pour ceux dont le ratio était supérieur à 0,19 (p = 0,004). La survi...

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The Prognostic Value of Lymph Node Ratio After Neoadjuvant Chemoradiation and Rectal Cancer Surgery

Cited by 34 publications

References 21 publications

Lymph Node Ratio is an Independent Prognostic Factor in Node Positive Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy Followed by Curative Resection

Lymph Node Ratio is an Independent Prognostic Factor in Node Positive Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy Followed by Curative Resection

Lymph node ratio is an independent prognostic factor for rectal cancer after neoadjuvant therapy: A meta‐analysis

Prognostic value of lymph node ratio in survival of patients with locally advanced rectal cancer

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