The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal Cancer
Background: This study was designed to validate the prognostic significance of the ratio of positive to examined lymph nodes (LNR) in patients with colorectal cancer.Methods: 218,314 patients from the SEER database and 1,811 patients from the three independent multicenter were included in this study...
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doaj-4de5b60c97104278a789bc25c8cb6cc22020-11-24T21:45:00ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2018-12-01810.3389/fonc.2018.00628421451The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal CancerChi-Hao Zhang0Yan-Yan Li1Qing-Wei Zhang2Alberto Biondi3Valeria Fico4Roberto Persiani5Xiao-Chun Ni6Meng Luo7Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Radiation Oncology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDivision of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, ChinaDipartimento Scienze Gastroenterologiche ed Endocrino-Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDipartimento Scienze Gastroenterologiche ed Endocrino-Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDipartimento Scienze Gastroenterologiche ed Endocrino-Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaBackground: This study was designed to validate the prognostic significance of the ratio of positive to examined lymph nodes (LNR) in patients with colorectal cancer.Methods: 218,314 patients from the SEER database and 1,811 patients from the three independent multicenter were included in this study. The patients were divided into 5 groups on a basis of previous published LNR: LNR0, patients with no metastatic lymph nodes; LNR1, patients with the LNR between 0.1 and 0.17; LNR2, patients with the LNR between 0.18 and 0.41; LNR3, patients with the LNR between 0.42 and 0.69; LNR4, patients with the LNR >0.7. The 5-year OS and CSS rate were estimated using Kaplan-Meier method and the survival difference was tested using log-rank test. Multivariate Cox analysis was used to further assess the influence of the LNR on patients' outcome.Results: The 5-year OS rate of patients within LNR0 to LNR4 group was 71.2, 55.8, 39.3, 22.6, and 14.6%, respectively (p < 0.001) in the SEER database. While the 5-year OS rate of those with LNR0 to LNR4 was 75.2, 66.1, 48.0, 34.0, and 17.7%, respectively (p < 0.001) in the international multicenter cohort. In the multivariate analysis, LNR was demonstrated to be a strong prognostic factor in patients with < 12 and ≥12 metastatic lymph nodes. Furthermore, the LNR had a similar impact on the patients' prognosis in colon cancer and rectal cancer.Conclusion: The LNR allowed better prognostic stratification than the positive node (pN) in patients with colorectal cancer and the cut-off values were well validated.https://www.frontiersin.org/article/10.3389/fonc.2018.00628/fullColorectal cancerlymph node ratioprognosisoverall survivalSEER database |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chi-Hao Zhang Yan-Yan Li Qing-Wei Zhang Alberto Biondi Valeria Fico Roberto Persiani Xiao-Chun Ni Meng Luo |
spellingShingle |
Chi-Hao Zhang Yan-Yan Li Qing-Wei Zhang Alberto Biondi Valeria Fico Roberto Persiani Xiao-Chun Ni Meng Luo The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal Cancer Frontiers in Oncology Colorectal cancer lymph node ratio prognosis overall survival SEER database |
author_facet |
Chi-Hao Zhang Yan-Yan Li Qing-Wei Zhang Alberto Biondi Valeria Fico Roberto Persiani Xiao-Chun Ni Meng Luo |
author_sort |
Chi-Hao Zhang |
title |
The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal Cancer |
title_short |
The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal Cancer |
title_full |
The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal Cancer |
title_fullStr |
The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal Cancer |
title_full_unstemmed |
The Prognostic Impact of the Metastatic Lymph Nodes Ratio in Colorectal Cancer |
title_sort |
prognostic impact of the metastatic lymph nodes ratio in colorectal cancer |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2018-12-01 |
description |
Background: This study was designed to validate the prognostic significance of the ratio of positive to examined lymph nodes (LNR) in patients with colorectal cancer.Methods: 218,314 patients from the SEER database and 1,811 patients from the three independent multicenter were included in this study. The patients were divided into 5 groups on a basis of previous published LNR: LNR0, patients with no metastatic lymph nodes; LNR1, patients with the LNR between 0.1 and 0.17; LNR2, patients with the LNR between 0.18 and 0.41; LNR3, patients with the LNR between 0.42 and 0.69; LNR4, patients with the LNR >0.7. The 5-year OS and CSS rate were estimated using Kaplan-Meier method and the survival difference was tested using log-rank test. Multivariate Cox analysis was used to further assess the influence of the LNR on patients' outcome.Results: The 5-year OS rate of patients within LNR0 to LNR4 group was 71.2, 55.8, 39.3, 22.6, and 14.6%, respectively (p < 0.001) in the SEER database. While the 5-year OS rate of those with LNR0 to LNR4 was 75.2, 66.1, 48.0, 34.0, and 17.7%, respectively (p < 0.001) in the international multicenter cohort. In the multivariate analysis, LNR was demonstrated to be a strong prognostic factor in patients with < 12 and ≥12 metastatic lymph nodes. Furthermore, the LNR had a similar impact on the patients' prognosis in colon cancer and rectal cancer.Conclusion: The LNR allowed better prognostic stratification than the positive node (pN) in patients with colorectal cancer and the cut-off values were well validated. |
topic |
Colorectal cancer lymph node ratio prognosis overall survival SEER database |
url |
https://www.frontiersin.org/article/10.3389/fonc.2018.00628/full |
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