Lymph node ratio is an independent prognostic factor in patients with rectal cancer treated with preoperative chemoradiotherapy and curative resection |
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Authors: | SD Lee TH Kim DY Kim JY Baek SY Kim HJ Chang SC Park JW Park JH Oh KH Jung |
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Institution: | 1. Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea;2. Department of Surgery, Daehang Hospital, Seoul, South Korea;3. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea |
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Abstract: | PurposeTo evaluate the prognostic effect of lymph node ratio (LNR) in patients with locally advanced rectal cancer who were treated with curative resection after preoperative chemoradiotherapy (CRT).MethodsBetween October 2001 and December 2007, 519 patients who had undergone curative resection of primary rectal cancer after preoperative CRT were enrolled. Of these, 154 patients were positive for lymph node (LN) metastasis and were divided into three groups according to the LNR (≤0.15 n = 80], 0.16–0.3 n = 44], >0.3 n = 30]) to evaluate the prognostic effect on overall survival (OS) and disease-free survival (DFS).ResultsLNR (≤0.15, 0.16–0.3, and >0.3) was significantly associated with 5-year OS (90.3%, 75.1%, and 45.1%; p < 0.001) and DFS (66.7%, 55.8%, and 21.9%; p < 0.001) rates. In a multivariate analysis, LNR (≤0.15, 0.16–0.3, and >0.3) was a significant independent prognostic factor for OS (hazard ratios HRs], 1, 3.609, and 8.197; p < 0.001) and DFS (HRs, 1, 1.699, and 3.960; p < 0.001). LNR had a prognostic impact on OS and DFS in patients with <12 harvested LNs, as well as in those with ≥12 harvested LNs (p < 0.05).ConclusionLNR was a significant independent prognostic predictor for OS and DFS in patients with locally advanced rectal cancer who were treated with curative resection after preoperative CRT. |
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Keywords: | Rectal cancer Preoperative Chemoradiotherapy Lymph node Lymph node ratio |
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