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