Adequate lymph node examination is essential to ensure the prognostic value of the lymph node ratio in patients with stage III colorectal cancer
Adequate lymph node examination is essential to ensure the prognostic value of the lymph node ratio in patients with stage III colorectal cancer
复制标题
DOI：
10.1007/s00595-010-4446-2
复制
发表时间：
2011-10-01
期刊：
影响因子：
2.5
通讯作者：
Ohdan, Hideki
中科院分区：
文献类型：
--
作者：
Shimomura, Manabu;Ikeda, Satoshi;Ohdan, Hideki
目的.本研究旨在评估淋巴结比率（LNR）的预后价值，通过将阳性淋巴结（LN）的数量除以检查的LN的数量来估计，与新肿瘤，淋巴结和转移（TNM）系统相比，III期结直肠癌，并评估检查的LN数量与LNR的预后价值之间的关系。我们回顾性分析了266例III期结直肠癌患者的临床病理资料。我们评估了LNR与TNM系统相比对预测癌症复发的影响，以及LNR对低LN计数患者的预后价值。在多因素分析中，发现LNR是癌症复发的独立危险因素。LNR的应用，加上新的TNM系统，比单独的TNM系统更能预测生存。在检查了足够数量LN的患者中观察到LNR的预后分离，但在LN计数低的患者中没有观察到。结合LNR和新的TNM系统，可以获得更强的预后分离。充分的淋巴结检查对于确保III期结直肠癌患者LNR的预后价值非常重要。
Purpose. This study aimed to assess the prognostic value of the lymph node ratio (LNR), estimated by dividing the number of positive lymph nodes (LNs) by the number of LNs examined, for stage III colorectal cancer in comparison to the new tumor, nodes, and metastasis (TNM) system, and to evaluate the relationship between the number of LNs examined and the prognostic value of the LNR.Methods. We retrospectively reviewed the clinicopathological data of a cohort of 266 patients with stage III colorectal cancer. We assessed the impact of LNR on the prediction of cancer recurrence in comparison to the TNM system, as well as the prognostic value of LNR in patients with a low LN count.Results. In multivariate analysis, the LNR was found to be an independent risk factor of cancer recurrence. The application of the LNR, in addition to the new TNM system, was more predictive of survival than the TNM system alone. A prognostic separation by LNR was observed in patients who had an adequate number of LNs examined, but not in patients with a low LN count.Conclusions. A stronger prognostic separation can be obtained by using the LNR together with the new TNM system. Adequate lymph node examination is important to ensure the prognostic value of LNR in patients with stage III colorectal cancer.