The prognostic superiority of log odds of positive lymph nodes in stage III colon cancer
The prognostic superiority of log odds of positive lymph nodes in stage III colon cancer
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DOI：
10.1007/s11605-008-0651-3
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发表时间：
2008-10-01
影响因子：
3.2
通讯作者：
Kulaylat, Mahmoud N.
中科院分区：
文献类型：
--
作者：
Wang, Jiping;Hassett, James M.;Kulaylat, Mahmoud N.
研究背景文献显示淋巴结比率（LNR）和淋巴结总数（TNODS）是淋巴结阳性结肠癌的独立预后因素。我们的研究评估了预后优势的对数几率阳性淋巴结（LODDS）在同一patientpopulation.Material和方法共24,477例III期结肠癌的SEER登记进行了审查。根据LNR将患者分类为LNR 1至LNR 4（根据临界点0.07、0.25和0.50），根据LODDS将患者分类为LODDS 1至LODDS 5（根据临界点-2.2、-1.1、0和1.1）。采用Kaplan-Meier和考克斯模型计算相对危险度（RR）和95%可信区间（CI）。两组的生存率有显著差异（5年生存率，33.5% vs. 23.3%，p < 0.0001）。单因素分析显示，LNR（RR=3.45，95% CI=3.26-3.66）或TNODS（RR=0.99，95% CI=0.986-0.99）越高，生存率越低。但在调整LODDS状态后，两者之间的相关性并不显著（LNR，RR=0.90，95%CI =0.65-1.24，p=0.52; TNODS，RR=1.001，95%CI =0.997-1.005，p=0.54）。先前报道的TNODS和LNR的预后相关性以及III期疾病的结局被LODDS混淆。
Background Literature showed that lymph node ratio (LNR) and total number of lymph nodes (TNODS) are independent prognostic factors in node-positive colon cancer. Our study assesses the prognostic superiority of the log odds of positive lymph nodes (LODDS) in the same patient population.Material and Methods A total of 24,477 stage III colon cancer cases from the SEER registry were reviewed. Patients were categorized based on LNR into LNR1 to LNR4, according to cutoff points 0.07, 0.25, and 0.50, and based on LODDS into LODDS1 to LODDS5, according to cutoff points -2.2, -1.1, 0, and 1.1. The relative risk (RR), and 95% confidence interval (CI) were evaluated using the method of Kaplan-Meier and Cox model.Results Patients with LNR4 could be classified into LODDS4 (61.4%) and LODDS5 (38.4%). The survival in these two groups was significantly different (5-year survival, 33.5% vs. 23.3%, p < 0.0001). Univariate analysis showed that the higher LNR (RR=3.45, 95% CI=3.26-3.66) or low TNODS (RR=0.99, 95% CI=0.986-0.99) was significantly associated with poor survival. However, after adjusting for LODDS status, the association did not appear to be significant (LNR, RR=0.90, 95% CI=0.65-1.24, p=0.52; TNODS, RR=1.001, 95% CI=0.997-1.005, p=0.54).Conclusion Colon cancer patients with LNR4 disease represent a heterogeneous group. The previously reported prognostic association of TNODS and LNR and outcome of stage III disease were confounded by LODDS.