Association of primary tumor lymph node ratio with burden of liver metastases and survival in stage IV colorectal cancer
Association of primary tumor lymph node ratio with burden of liver metastases and survival in stage IV colorectal cancer
复制标题
DOI：
10.21037/hbsn.2016.08.08
复制
发表时间：
2017-06-01
影响因子：
8
通讯作者：
Katz, Steven C.
中科院分区：
文献类型：
--
作者：
Ahmad, Ali;Reha, Jeffrey;Katz, Steven C.
背景：我们研究的主要目的是评估 IV 期结直肠腺癌 (CRC) 中原发肿瘤淋巴结比率 (LNR) 与总生存率 (OS) 和肝脏转移性疾病范围的关系。 方法：我们分析了 53 名接受原发肿瘤手术切除的 IV 期 CRC 患者的数据。中位 LNR 0.25 用于将患者分为高 LNR (H-LNR) 组和低 LNR (L-LNR) 组。使用卡方检验和多元回归模型进行统计比较。使用 Kaplan-Meier (KM) 方法计算 OS，同时使用 cox 回归进行多变量分析。 结果：H-LNR 状态与 > 3 个肝转移 (LM) 的存在相关 [优势比 (OR)：2.43，P=0.047] 和双叶 LM（OR：3.94，P=0.039）。与 L-LNR 患者相比，整个队列中 H-LNR 患者的 OS 显着较差（3 年时为 9% vs. 34%，P=0.027）。 H-LNR 组因 LM 接受肝切除术的患者的 5 年 OS 也显着较差（0% vs. 37%，P=0.013）。多变量分析表明，LNR 与生存率独立相关 [HR：2.63； 95%置信区间（CI），1.13-6.14； P=0.025]。结论：在IV期CRC中，LNR与肝肿瘤负荷程度相关，并且是接受肝切除的患者生存的独立预测因子。
Background: The primary objective of our study was to assess the association of primary tumor lymph node ratio (LNR) in stage IV colorectal adenocarcinomas (CRC) with overall survival (OS) and the extent of metastatic disease in the liver.Methods: We analyzed data on 53 stage IV CRC patients who underwent surgical resection of the primary tumor. The median LNR of 0.25 was used to stratify patients into high LNR (H-LNR) and low LNR (L-LNR) groups. Statistical comparison was performed using chi square test and multiple regression models. OS was calculated using the Kaplan-Meier (KM) method while cox regression was used for multivariate analysis.Results: H-LNR status was associated with the presence of > 3 liver metastases (LM) [odds ratio (OR): 2.43, P=0.047] and bilobar LM (OR: 3.94, P=0.039). The OS in H-LNR patients was significantly worse in the entire cohort compared to L-LNR (9% vs. 34% at 3 years, P=0.027). The 5-year OS in patients undergoing liver resection for LM was also significantly worse in the H-LNR group (0% vs. 37%, P=0.013). LNR was independently associated with survival on multivariate analysis [HR: 2.63; 95% confidence intervals (CI), 1.13-6.14; P=0.025].Conclusions: In stage IV CRC, LNR is associated with the extent of hepatic tumor burden and was an independent predictor of survival in patients undergoing liver resection.