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Prognostic Significance of the Lymph Node Ratio in Stage IV Colorectal Cancer Patients who have Undergone Curative Resection

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The lymph node ratio (LNR) was proposed as a prognostic indicator in Stage III colorectal cancer (CRC) patients in recent studies. The purpose of this study was to evaluate the prognostic impact of the LNR in Stage IV CRC patients who have undergone curative resection.

Methods

A retrospective review of 119 Stage IV CRC patients who underwent curative resection in our institute from 1997 to 2009 was performed. Patients were divided into two groups (low LNR and high LNR) by means of their median LNR. A disease-free survival (DFS) and an overall survival (OS) were analyzed using the Kaplan–Meier curve; multivariate analysis was performed using the Cox proportional hazard model.

Results

The cutoff value for the LNR was 0.111. For the entire study group, the 5-year DFS was 22 % and the 5-year OS was 65 %. DFS was not significantly different between patients in the low LNR group and the high LNR group (25 and 19 %, respectively; P = 0.317), but OS was significantly higher in the low LNR group patients compared with the high LNR group patients (77 and 54 %, respectively; P < 0.001). Using multivariate analysis, we identified the LNR as an independent prognostic factor for OS, with a hazard ratio of 3.08 (95 % CI 1.38–8.19; P = 0.005).

Conclusions

LNR is a potent prognostic indicator for stratification in Stage IV CRC patients who have undergone curative resection.

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Disclosure

All of authors declare no conflicts of interest or financial ties to disclosure.

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Authors and Affiliations

  1. Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan

    Tsuyoshi Ozawa MD, Soichiro Ishihara MD, Takeshi Nishikawa MD, Toshiaki Tanaka MD, Junichiro Tanaka MD, Tomomichi Kiyomatsu MD, Keisuke Hata MD, Kazushige Kawai MD, Hiroaki Nozawa MD, Takamitsu Kanazawa MD, Shinsuke Kazama MD, Hironori Yamaguchi MD, Eiji Sunami MD, Joji Kitayama MD & Toshiaki Watanabe MD

Authors
  1. Tsuyoshi Ozawa MD
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  2. Soichiro Ishihara MD
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  3. Takeshi Nishikawa MD
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  4. Toshiaki Tanaka MD
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  5. Junichiro Tanaka MD
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  6. Tomomichi Kiyomatsu MD
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  7. Keisuke Hata MD
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  8. Kazushige Kawai MD
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  9. Hiroaki Nozawa MD
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  10. Takamitsu Kanazawa MD
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  11. Shinsuke Kazama MD
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  12. Hironori Yamaguchi MD
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  13. Eiji Sunami MD
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  14. Joji Kitayama MD
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  15. Toshiaki Watanabe MD
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Corresponding author

Correspondence to Tsuyoshi Ozawa MD.

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Ozawa, T., Ishihara, S., Nishikawa, T. et al. Prognostic Significance of the Lymph Node Ratio in Stage IV Colorectal Cancer Patients who have Undergone Curative Resection. Ann Surg Oncol 22, 1513–1519 (2015). https://doi.org/10.1245/s10434-014-4184-6

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  • DOI: https://doi.org/10.1245/s10434-014-4184-6

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