AIM: To evaluate the predictive value of the lymph node (LN) ratio (LNR, number of metastatic LNs/ examined LNs) for recurrence in patients with rectal cancer and to compare its applicability according to preoperative chemoradiotherapy (PCRT). METHODS: From 2000 to 2009, 967 patients with metastatic LNs after curative resection for locally advanced rectal cancer were identified. Patients were categorized according to PCRT (PCRT vs No PCRT). The cut-off LNR was determined based on the pN1 vs pN2 when the recommended number of LNs was harvested. The 5-year recurrence-free survival (RFS) rates using the Kaplan-Meier method were compared according to p/yp N stage and the LNR in each group. RESULTS: Among patients with the same p/ypN stage, the 5-year RFS rate differed according to the LNR. In addition, the 5-year RFS rate was significantly different between pN and LNR groups in patients with No PCRT. In PCRT group, however, only LNR was associated with prognosis. On multivariate analysis, both pN and LNR were significant independent prognostic factors for 5-year RFS in the No PCRT group. In the PCRT group, only LNR category was found to be associated with RFS (HR = 2.36, 95%CI: 1.31-3.84, and P = 0.001). CONCLUSION: The LNR is an important prognostic predictor of RFS in rectal cancer patients especially treated with PCRT. Current pN categories could not discriminate between prognostic groups of RFS after PCRT.
AIM: To evaluate the predictive value of the lymph node (LN) ratio (LNR, number of metastatic LNs/ examined LNs) for recurrence in patients with rectal cancer and to compare its applicability according to preoperative chemoradiotherapy (PCRT). METHODS: From 2000 to 2009, 967 patients with metastatic LNs after curative resection for locally advanced rectal cancer were identified. Patients were categorized according to PCRT (PCRT vs No PCRT). The cut-off LNR was determined based on the pN1 vs pN2 when the recommended number of LNs was harvested. The 5-year recurrence-free survival (RFS) rates using the Kaplan-Meier method were compared according to p/yp N stage and the LNR in each group. RESULTS: Among patients with the same p/ypN stage, the 5-year RFS rate differed according to the LNR. In addition, the 5-year RFS rate was significantly different between pN and LNR groups in patients with No PCRT. In PCRT group, however, only LNR was associated with prognosis. On multivariate analysis, both pN and LNR were significant independent prognostic factors for 5-year RFS in the No PCRT group. In the PCRT group, only LNR category was found to be associated with RFS (HR = 2.36, 95%CI: 1.31-3.84, and P = 0.001). CONCLUSION: The LNR is an important prognostic predictor of RFS in rectal cancerpatients especially treated with PCRT. Current pN categories could not discriminate between prognostic groups of RFS after PCRT.
Authors: Rolf Sauer; Heinz Becker; Werner Hohenberger; Claus Rödel; Christian Wittekind; Rainer Fietkau; Peter Martus; Jörg Tschmelitsch; Eva Hager; Clemens F Hess; Johann-H Karstens; Torsten Liersch; Heinz Schmidberger; Rudolf Raab Journal: N Engl J Med Date: 2004-10-21 Impact factor: 91.245
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Authors: T E Le Voyer; E R Sigurdson; A L Hanlon; R J Mayer; J S Macdonald; P J Catalano; D G Haller Journal: J Clin Oncol Date: 2003-08-01 Impact factor: 44.544
Authors: Alberto Marchet; Simone Mocellin; Alessandro Ambrosi; Paolo Morgagni; Domenico Garcea; Daniele Marrelli; Franco Roviello; Giovanni de Manzoni; Annamaria Minicozzi; Giovanni Natalini; Francesco De Santis; Luca Baiocchi; Arianna Coniglio; Donato Nitti Journal: Ann Surg Date: 2007-04 Impact factor: 12.969
Authors: Salem Y Mohamed; Randa Mohamed Kaf; Mona Mostafa Ahmed; Amira Elwan; Hassan R Ashour; Amr Ibrahim Journal: J Gastrointest Cancer Date: 2019-12
Authors: Chan Wook Kim; Jihun Kim; Seung-Seop Yeom; Jong Lyul Lee; Yong Sik Yoon; In Ja Park; Seok-Byung Lim; Seunghee Baek; Chang Sik Yu; Jin Cheon Kim Journal: Oncotarget Date: 2017-05-26