Prognostic value of the lymph node ratio in surgically treated stage III colorectal cancer patients with high numbers of harvested lymph nodes.

Eren T. T. , Tigrel L. Z. , Gapbarov A., Aydemir M. A. , Seneldir H., Ekinci O., ...More

Acta chirurgica Belgica, pp.1-9, 2022 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2022
  • Doi Number: 10.1080/00015458.2022.2103247
  • Journal Name: Acta chirurgica Belgica
  • Journal Indexes: Science Citation Index Expanded
  • Page Numbers: pp.1-9
  • Keywords: Colorectal neoplasms, lymph nodes, general surgery, prognosis, survival, COLON-CANCER, SURVIVAL, DISSECTION


Background: The lymph node ratio (LNR), defined as the number of positive lymph nodes

(LN) divided by the total number of harvested LN, has been demonstrated to be an independent

factor in the prognosis of surgically treated colorectal cancer (CRC) patients. This

study aims to establish the prognostic value of LNR in stage III CRC patients with high numbers

of LN removed.

Methods: Stage III CRC patients who underwent curative resections over an 8-year period

were included to the study. Demographics, clinicopathological features, surgical as well as

recurrence and survival outcomes were recorded and statistically analyzed. Calculations for

LNR were carried out as a function of percentage rates and Cox proportional hazards regression

analyses were performed to determine its effect on disease-free and overall survival.

Results: Among a total of 493 surgically treated CRC cases, 104 patients were included to

the study consisting of 68 (65.4%) men and 36 (34.6%) women with a median age of 64

(inter-quartile range: 55–74) years. The mean number of harvested LN was 31.6 ± 21.0 (range:

12–103). Multivariate Cox regression analyses proved LNR to be a significant factor in both

disease-free and overall survival (p¼0.007 and p¼0.003, respectively). Forward elimination

analyses showed that a 1% increase in LNR resulted with a 2% increase in both the risks of

recurrence and mortality.

Conclusions: The LNR may be assessed as an adjunct to the current staging systems for the

prediction of oncological outcomes and survival of surgically treated stage III CRC patients.