Prognostic value of the ratio between positive lymph nodes and total excised lymph nodes in colorectal cancer

Abstract

Objective: Recent studies show that the number of excised lymph nodes is an independent prognostic factor for colorectal cancer. Based on this information, lymph node ratio (the ratio of metastatic lymph node number to the total excised lymph node number) is a reliable marker for determining prognosis in colorectal cancer. In this study, we aimed to study the prognostic effect of lymph node ratio in non-metastatic colorectal cancers from patients who underwent surgery in our hospital between January 2008 and January 2013. Materials and methods: In this study evaluated the prognostic value of lymph node ratio in non-metastatic colorectal cancer patients who underwent surgery for immediate causes or elective causes in our hospital between January 2008 and January 2013. The study group consists of 352 patients and includes pathology reports, laboratory data, clinical observations. Results: When we stratified 204 (58%) men and 148 (42%) women, s according to LNR, we found that group 1 (LNR = 0) included 195 patients (55.4%), group 2 (LNR = 0.01-0.17) included 56 patients (15.9%), group 3 (LNR = 0.18-0.41) included 56 patients (15.9%), group 4 (LNR = 0.42-0.69) included 27 patients (7.7%), and group 5 (LNR = 0.70) included18 patients (5.1%). Increased LNR was associated with a significantly greater mortality risk. However, LNR stratification was not significantly associated with clinical outcomes. Conclusion: Our results demonstrate that elevated LNR is associated with a higher rate of recurrence and poorer long-term prognosis. As is the case with many types of cancer, presence of lymph node metastasis is a significant component of tumor staging. TNM classification, which is currently the most commonly used staging system for colon cancer, does not include the total number of excised lymph nodes. We believe that future studies on LNR will draw attention to this shortcoming of the current staging system and provide evidence for LNR to be included as a standard of staging.