Omid Ahmadi1, Mark D Stringer, Michael A Black, John L McCall. 1. Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Department of Anatomy, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand.
Abstract
BACKGROUND: Lymph node yield (LNY) and lymph node ratio (LNR) are recognized as independent prognostic factors in colorectal cancer (CRC). OBJECTIVES: To examine the relationship between LNY and other clinico-pathological variables, and the prognostic value of LNY and LNR on patient survival in CRC. METHODS: The clinico-pathological and survival data for patients diagnosed from January 2000 to July 2012 were retrieved from the New Zealand Cancer Registry. Multiple linear regression was used to identify clinico-pathological factors influencing LNY, and Cox regression was used to determine the association between LNY and LNR and patient survival. RESULTS: 14,646 patients were included in the study (mean age 70.3 years, 50.1% male). Mean LNY was 17.4. Younger age, right-sided disease, higher T stage, female sex and no neoadjuvant radiotherapy (rectal cancer) were all associated with higher LNY (P ≤ 0.001). Overall survival in Stage I-III disease increased with higher LNY (for LNY ≥ 12, HR = 0.67, 95% CI 0.64-0.72; P < 0.001). Survival in Stage III-IV disease was inversely related to LNR (HR = 0.56, 95% CI 0.51-0.62; P < 0.001). CONCLUSION: LNY is influenced by patient age, site of disease and T stage. LNY (Stage I-II) and LNR (Stage III-IV) have independent prognostic value in CRC.
BACKGROUND: Lymph node yield (LNY) and lymph node ratio (LNR) are recognized as independent prognostic factors in colorectal cancer (CRC). OBJECTIVES: To examine the relationship between LNY and other clinico-pathological variables, and the prognostic value of LNY and LNR on patient survival in CRC. METHODS: The clinico-pathological and survival data for patients diagnosed from January 2000 to July 2012 were retrieved from the New Zealand Cancer Registry. Multiple linear regression was used to identify clinico-pathological factors influencing LNY, and Cox regression was used to determine the association between LNY and LNR and patient survival. RESULTS: 14,646 patients were included in the study (mean age 70.3 years, 50.1% male). Mean LNY was 17.4. Younger age, right-sided disease, higher T stage, female sex and no neoadjuvant radiotherapy (rectal cancer) were all associated with higher LNY (P ≤ 0.001). Overall survival in Stage I-III disease increased with higher LNY (for LNY ≥ 12, HR = 0.67, 95% CI 0.64-0.72; P < 0.001). Survival in Stage III-IV disease was inversely related to LNR (HR = 0.56, 95% CI 0.51-0.62; P < 0.001). CONCLUSION: LNY is influenced by patient age, site of disease and T stage. LNY (Stage I-II) and LNR (Stage III-IV) have independent prognostic value in CRC.
Authors: F Bianco; S De Franciscis; A Belli; A Falato; R Fusco; D F Altomare; A Amato; C R Asteria; A Avallone; G A Binda; L Boccia; P Buzzo; M Carvello; C Coco; P Delrio; P De Nardi; M Di Lena; A Failla; F La Torre; M La Torre; M Lemma; P Luffarelli; G Manca; I Maretto; F Marino; A Muratore; A Pascariello; S Pucciarelli; D Rega; V Ripetti; G Rizzo; A Serventi; A Spinelli; F Tatangelo; E D L Urso; G M Romano Journal: Tech Coloproctol Date: 2017-02-13 Impact factor: 3.781