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Prognostic impact of the Lymph node ratio in rectal cancer patients who underwent preoperative chemoradiation
Author(s) -
Kang Jeonghyun,
Hur Hyuk,
Min Byung Soh,
Lee Kang Young,
Kim Nam Kyu
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21913
Subject(s) - medicine , lymph node , colorectal cancer , multivariate analysis , abdominoperineal resection , oncology , stage (stratigraphy) , overall survival , t stage , cancer , paleontology , biology
Aim The purpose of this study was to investigate the prognostic impact of the lymph node ratio (LNR) in ypN‐positive rectal cancer patients who received preoperative chemoradiation (preop‐CRT). Methods A total of 75 patients diagnosed as node‐positive after undergoing preop‐CRT followed by curative resection were enrolled. Patients were categorized into two groups based on their median LNR, 0.143. Results The median metastatic and retrieved lymph node numbers were 2.0 (range: 1–79) and 18.0 (range: 5–80). Abdominoperineal resection, circumferential resection margin involvement and higher LNR were proven to be independent adverse prognostic factors affecting survival in the multivariate analysis including LNR as a covariate. Of the 47 patients with ypN1, 35 (74.5%) showed a lower LNR (N1G1) and 12 (25.5%) showed a higher LNR (N1G2). The N1G1 group showed better overall survival than the N1G2 group ( P = 0.018). There was no difference between the survival rates of the N1G2 group and the ypN2 group ( P = 0.987). Conclusions LNR is an independent prognostic factor after preop‐CRT for rectal cancer. LNR showed better prognosis stratification than the ypN stage. Therefore, LNR should be considered as an additional prognostic factor in node‐positive rectal cancer after preop‐CRT. J. Surg. Oncol. 2011;104:53–58. © 2011 Wiley‐Liss, Inc.