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Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer

BACKGROUND: Lymph node yield (LNY) of 12 or more in resection of colorectal cancer is recommended in current international guidelines. Although a low LNY (less than 12) is associated with poorer outcome in some studies, its prognostic value is unclear in patients with early‐stage colorectal or recta...

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Autores principales: Lee, C. H. A., Wilkins, S., Oliva, K., Staples, M. P., McMurrick, P. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354193/
https://www.ncbi.nlm.nih.gov/pubmed/30734020
http://dx.doi.org/10.1002/bjs5.96
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author Lee, C. H. A.
Wilkins, S.
Oliva, K.
Staples, M. P.
McMurrick, P. J.
author_facet Lee, C. H. A.
Wilkins, S.
Oliva, K.
Staples, M. P.
McMurrick, P. J.
author_sort Lee, C. H. A.
collection PubMed
description BACKGROUND: Lymph node yield (LNY) of 12 or more in resection of colorectal cancer is recommended in current international guidelines. Although a low LNY (less than 12) is associated with poorer outcome in some studies, its prognostic value is unclear in patients with early‐stage colorectal or rectal cancer with a complete pathological response following neoadjuvant therapy. Lymph node ratio (LNR), which reflects the proportion of positive to total nodes obtained, may be more accurate in predicting outcome in stage III colorectal cancer. This study aimed to identify factors correlating with LNY and evaluate the prognostic role of LNY and LNR in colorectal cancer. METHODS: An observational study was performed on patients with colorectal cancer treated at three hospitals in Melbourne, Australia, from January 2010 to March 2016. Association of LNY and LNR with clinical variables was analysed using linear regression. Disease‐free (DFS) and overall (OS) survival were investigated with Cox regression and Kaplan–Meier survival analyses. RESULTS: Some 1585 resections were analysed. Median follow‐up was 27·1 (range 0·1–71) months. Median LNY was 16 (range 0–86), and was lower for rectal cancers, decreased with increasing age, and increased with increasing stage. High LNY (12 or more) was associated with better DFS in colorectal cancer. Subgroup analysis indicated that low LNY was associated with poorer DFS and OS in stage III colonic cancer, but had no effect on DFS and OS in rectal cancer (stages I–III). Higher LNR was predictive of poorer DFS and OS. CONCLUSION: Low LNY (less than 12) was predictive of poor DFS in stage III colonic cancer, but was not a factor for stage I or II colonic disease or any rectal cancer. LNR was a predictive factor in DFS and OS in stage III colonic cancer, but influenced DFS only in rectal cancer.
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spelling pubmed-63541932019-02-07 Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer Lee, C. H. A. Wilkins, S. Oliva, K. Staples, M. P. McMurrick, P. J. BJS Open Original Articles BACKGROUND: Lymph node yield (LNY) of 12 or more in resection of colorectal cancer is recommended in current international guidelines. Although a low LNY (less than 12) is associated with poorer outcome in some studies, its prognostic value is unclear in patients with early‐stage colorectal or rectal cancer with a complete pathological response following neoadjuvant therapy. Lymph node ratio (LNR), which reflects the proportion of positive to total nodes obtained, may be more accurate in predicting outcome in stage III colorectal cancer. This study aimed to identify factors correlating with LNY and evaluate the prognostic role of LNY and LNR in colorectal cancer. METHODS: An observational study was performed on patients with colorectal cancer treated at three hospitals in Melbourne, Australia, from January 2010 to March 2016. Association of LNY and LNR with clinical variables was analysed using linear regression. Disease‐free (DFS) and overall (OS) survival were investigated with Cox regression and Kaplan–Meier survival analyses. RESULTS: Some 1585 resections were analysed. Median follow‐up was 27·1 (range 0·1–71) months. Median LNY was 16 (range 0–86), and was lower for rectal cancers, decreased with increasing age, and increased with increasing stage. High LNY (12 or more) was associated with better DFS in colorectal cancer. Subgroup analysis indicated that low LNY was associated with poorer DFS and OS in stage III colonic cancer, but had no effect on DFS and OS in rectal cancer (stages I–III). Higher LNR was predictive of poorer DFS and OS. CONCLUSION: Low LNY (less than 12) was predictive of poor DFS in stage III colonic cancer, but was not a factor for stage I or II colonic disease or any rectal cancer. LNR was a predictive factor in DFS and OS in stage III colonic cancer, but influenced DFS only in rectal cancer. John Wiley & Sons, Ltd 2018-08-08 /pmc/articles/PMC6354193/ /pubmed/30734020 http://dx.doi.org/10.1002/bjs5.96 Text en © 2018 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Lee, C. H. A.
Wilkins, S.
Oliva, K.
Staples, M. P.
McMurrick, P. J.
Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer
title Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer
title_full Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer
title_fullStr Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer
title_full_unstemmed Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer
title_short Role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer
title_sort role of lymph node yield and lymph node ratio in predicting outcomes in non‐metastatic colorectal cancer
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354193/
https://www.ncbi.nlm.nih.gov/pubmed/30734020
http://dx.doi.org/10.1002/bjs5.96
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