Ratio of Metastatic to Resected Lymph Nodes as a Prognostic Factor in Node-Positive Colorectal Cancer
Ratio of Metastatic to Resected Lymph Nodes as a Prognostic Factor in Node-Positive Colorectal Cancer
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DOI：
10.1245/s10434-010-1015-2
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发表时间：
2010-10-01
影响因子：
3.7
通讯作者：
Kim, Hyeong Rok
中科院分区：
文献类型：
--
作者：
Huh, Jung Wook;Kim, Young Jin;Kim, Hyeong Rok
背景本研究旨在评估淋巴结阳性结直肠癌（CRC）患者转移淋巴结与切除淋巴结的比值（LNR）的预后价值。从1998年5月到2007年12月，分析了总共514名接受根治性手术并确诊淋巴结转移的CRC患者的数据。根据四分位数将患者分为四组：LNR 1（0.18和= 0.34）。切除和转移淋巴结的中位数分别为14（范围，2-67）和2（范围，1-31）。中位随访期为48.5个月，LNR 1、LNR 2、LNR 3和LNR 4患者的5年总生存率分别为79、72、62和55 LNR 1、LNR 2、LNR 3和LNR 4患者的5年无病生存率分别为73、67、54和42%（P < 0.001）。在多变量分析中，LNR是总体（P = 0.012）和无病生存期（P = 0.009）的独立预后因素，pT和pN分类也是如此。在12个淋巴结的患者中，LNR仍具有统计学意义。除了常规的pT和pN类别之外。LNR是淋巴结阳性结直肠癌患者总生存期和无病生存期的预测因子。它可以弥补CRC手术中淋巴结清扫不充分的问题。
Background. This study was designed to assess the prognostic value of the ratio of metastatic to resected lymph nodes (lymph node ratio [LNR]) in patients with node-positive colorectal cancer (CRC).Methods. From May 1998 to December 2007, data from a total of 514 patients who underwent curative surgery for CRC with proven lymph node metastases were analyzed. Patients were categorized into four groups on the basis of quartiles: LNR1 (0.18 and = 0.34).Results. The median numbers of resected and metastatic nodes were 14 (range, 2-67) and 2 (range, 1-31), respectively. With a median follow-up period of 48.5 months, the 5-year overall survival rates of patients with LNR1, LNR2, LNR3, and LNR4 were 79, 72, 62, and 55%, respectively (P < 0.001); the 5-year disease-free survival rates of patients with LNR1, LNR2, LNR3, and LNR4 were 73, 67, 54, and 42%, respectively (P < 0.001). In the multivariate analysis, the LNR was an independent prognostic factor for both overall (P = 0.012) and disease-free survival (P -= 0.009), as were pT and pN category. LNR remained statistically significant both in patients with 12 nodes retrieved.Conclusions. In addition to the conventional pT and pN categories. the LNR was a predictor of both the overall and disease-free survival in patients with node-positive CRC. It may compensate for an inadequate lymph node dissection in surgery for CRC.