PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS
Yıl: 2022 Cilt: 29 Sayı: 4 Sayfa Aralığı: 661 - 670 Metin Dili: İngilizce DOI: 10.17343/sdutfd.1193868 İndeks Tarihi: 02-01-2023
PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS
Öz: Objective Colorectal cancers (CRCs) are among the most com- mon cancers all over the world with a high mortality rate. Many prognostic factors have been identified for these cancers, one of which is the lymph node ratio (LNR). The purpose of this study was to reveal the prognostic importance of the LNR in stage III CRCs. Material and Method The records of stage III colorectal patients who received adjuvant chemotherapy between January 1998 and May 2014 were examined retrospectively. Similar to the literature, the patients were divided into three groups according to their LNRs. Those with a ratio of 0–0.20 were in the 1st group, with 0.21–0.50 were in the 2nd group, and with 0.51–1 were in the 3rd group. Demographic characteristics of the patients, number of positive and total lymph nodes removed, lymph node positivity rate, presence of free tumor nodules, and survival were evaluated. Results A total of 263 patients were included in the study. While 163 (61.9%) of the patients were male, the median age was 62 (min: 25–max: 85). The mean number of lymph nodes removed was 17.46 (±11.55), and the mean number of positive lymph nodes was 3.48 (±5.13). The mean duration of disease-free survival (DFS) was 65.2 (±46.07) months (min = 6, max = 223). The mean overall survival time (OS) was 70.9 (±44.4) months (min = 6, max = 223). In univariate analysis, it was observed that as the LNR increased, recurrence and mortality increased statistically significantly (P < 0.001). According to the results of multivariate analysis, the relationship of DFS and OS with the LNR groups was statistically significant (P = 0.030 and P = 0.019, respectively). Conclusion The LNR in operated stage III CRC is an effective prognostic factor on DFS and OS.
Anahtar Kelime: EVRE III KOLOREKTAL KANSERLERDE LENF NODU POZİTİFLİK ORANININ PROGNOSTİK ÖNEMİ
Öz: Amaç Kolorektal kanserler, tüm dünyada sık görülen ve mortalitesi yüksek kanserlerdendir. Bu kanserler ile ilgili birçok prognostik faktör tanımlanmıştır. Bunlardan bir tanesi de lenf nodu pozitiflik oranıdır. Bu çalışmanın amacı, Evre III kolorektal kanserlerde lenf nodu pozitiflik oranının prognostik önemini ortaya koymaktır. Gereç ve Yöntem Ocak 1998 ile Mayıs 2014 tarihleri arasında kolorektal kanser tanısı ile opere edilip adjuvan kemoterapi alan, evre III hastaların kayıtları retrospektif olarak incelendi. Hastalar literatüre benzer şekilde lenf nodu pozitiflik oranına göre 0-0,20 arası olanlar 1. grup, 0,21-0,50 arası olanlar 2. grup ve 0,51-1 arası olanlar 3. grup şeklinde üç gruba ayrıldı. Hastaların demografik özellikleri, çıkarılan pozitif ve toplam lenf nodu sayısı, lenf nodu pozitiflik oranı, serbest tümör nodülü varlığı ve sağ kalım verileri incelendi. Bulgular Çalışmaya 263 hasta dâhil edildi. Hastaların 163’ü (%61,9) erkek iken, yaş ortanca değeri 62 (min: 25-max:85) idi. Ortalama çıkarılan lenf nodu sayısı 17.46 (±11.55) ve ortalama pozitif lenf nodu sayısı 3.48 (±5.13) idi. Hastalıksız sağkalım süresi ortalama 65,2(±46,07) ay (min=6, max=223) idi. Genel sağkalım süresi ortalama 70,9 (±44,4) ay (min=6, max=223) idi. Hastalıksız sağkalım ve genel sağkalım ile lenf nodu grupları arasındaki ilişki tek değişkenli analizde incelendiğinde; lenf nodu pozitiflik oranını arttıkça nüksün ve mortalitenin istatistiksel olarak anlamlı şekilde arttığı gözlendi (p<0,001). Çok değişkenli analiz sonuçlarına göre de hastalıksız sağkalım ve genel sağkalım ile lenf nodu pozitiflik oranını grupları arasındaki ilişki [sırasıyla (p=0,030), (p=0,019)] istatistiksel olarak anlamlı bulundu. Sonuç Opere evre III kolorektal kanserlerde lenf nodu pozitiflik oranın hastalıksız sağ kalım ve genel sağ kalım üzerine, etkili bir prognostik faktördür.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71(3):209-49.
- 2. Ladabaum U, Dominitz JA, Kahi C, Schoen RE. Strategies for Colorectal Cancer Screening. Gastroenterology 2020;158(2):418-32.
- 3. Li Y, Wu G, Zhang Y, Han B, Yang W, Wang X, et al. Log odds of positive lymph nodes as a novel prognostic predictor for colorectal cancer: a systematic review and meta-analysis. BMC Cancer 2022;18;22(1):290.
- 4. Bilimoria KY, Palis B, Stewart AK, Bentrem DJ, Freel AC, Sigurdson ER, et al. Impact of tumor location on nodal evaluation for colon cancer. Dis Colon Rectum 2008; 51(2):154-61.
- 5. Ceelen W, Nieuwenhove YV, Pattyn P. Prognostic value of the lymph node ratio in stage III colorectal cancer: a systematic review. Ann Surg Oncol 2010;17(11):2847-55.
- 6. Siegel RC, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019;69(1):7-34.
- 7. Compton CC, Fielding LP, Burgart LJ, Conley B, Cooper HS, Hamilton SR, et al. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 2000;124(7):979-94.
- 8. Baidoun F,Elshiwy K, Elkeraie Y, Merjaneh Z, Khoudari G, Sarmini MT, et al. Colorectal Cancer Epidemiology: Recent Trends and Impact on Outcomes. Curr Drug Targets 2021;22(9):998-1009.
- 9. Chang GJ, Rodriguez-Bigas MA, Skibber JM, Moyer VA. Lymph node evaluation and survival after curative resection of colon cancer: systematic review. J Natl Cancer Inst 2007;21;99(6):433-41.
- 10. Moon JY, Lee MR, Ha GW. Prognostic value of tumor deposits for long-term oncologic outcomes in patients with stage III colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis 2022;37(1):141-51.
- 11. Ramos-Esquivel A, Juárez M, González I, Porras J, Rodriguez L. Prognosis impact of the lymph node ratio in patients with colon adenocarcinoma: a single-centre experience. J Gastrointest Cancer 2014;45(2):133-36.
- 12. Sabbagh C, Mauvais F, Cosse C, Rebibo L, Joly JP, Dromer D, et al. A lymph node ratio of 10% is predictive of survival in stage III colon cancer: a French regional study. Int Surg 2014;99(4):344-53.
- 13. Sugimoto K, Sakamoto K, Tomiki Y, Goto M, Kotake K, Sugihara K. Proposal of new classification for stage III colon cancer based on the lymph node ratio: analysis of 4,172 patients from multi-institutional database in Japan. Ann Surg Oncol 2015;22(2):528-34.
- 14. Bando E, Yonemura Y, Taniguchi K, Fushida S, Fujimura T, Miwa K, et al. Outcome of ratio of lymph node metastasis in gastric carcinoma Ann Surg Oncol 2002;9(8):775-84.
- 15. Woodward WA, Vinh-Hung V, Ueno NT, Cheng YC, Royce M, Georges Vlastos PT, et al. Prognostic value of nodal ratios in node-positive breast cancer. J Clin Oncol 2006;20;24(18):2910-16.
- 16. Berger AC, Sigurdson ER, LeVoyer T, Hanlon A, Mayer RJ, Macdonald JS, et al. Colon cancer survival is associated with decreasing ratio of metastatic to examined lymph nodes. J Clin Oncol 2005;1;23(34):8706-12.
- 17. Klos CL, Bordeianou LG, Sylla P, Chang Y, Berger DL. The prognostic value of lymph node ratio after neoadjuvant chemoradiation and rectal cancer surgery. Dis Colon Rectum 2011;54(2):171-75.
- 18. Garcia B, Guzman C, Johnson C, Hellenthal NJ, Monie D, Monzon JR. Trends in lymph node excision and impact of positive lymph node ratio in patients with colectomy for primary colon adenocarcinoma: Population based study 1988 to 2011. Surg Oncol 2016;25(3):158-63.
- 19. Leonard D, Remue C, Orabi NA, Maanen A, Danse E, Dragean A, et al. Lymph node ratio and surgical quality are strong prognostic factors of rectal cancer: results from a single referral centre. Colorectal Dis 2016;18(6):O175-84.
- 20. Shen SS, Haupt BX, Ro JY, Zhu J, Bailey HR, Schwartz MR. Number of lymph nodes examined and associated clinicopathologic factors in colorectal carcinoma. Arch Pathol Lab Med 2009;133(5):781-86.
- 21. Gonsalves WI, Kanuri S, Tashi T, Aldoss I, Sama A, Al-Howaidi I, et al. Clinicopathologic factors associated with lymph node retrieval in resectable colon cancer: a Veterans' Affairs Central Cancer Registry (VACCR) database analysis. J Surg Oncol 2011;104(6):667-71.
| APA | Erdoğan K, yılmaz n, ERDOĞAN A, sutcuoglu o, Yazıcı O, Ozdemir N (2022). PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. , 661 - 670. 10.17343/sdutfd.1193868 |
| Chicago | Erdoğan Kübra,yılmaz nisbet,ERDOĞAN AHMET,sutcuoglu osman,Yazıcı Ozan,Ozdemir Nuriye PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. (2022): 661 - 670. 10.17343/sdutfd.1193868 |
| MLA | Erdoğan Kübra,yılmaz nisbet,ERDOĞAN AHMET,sutcuoglu osman,Yazıcı Ozan,Ozdemir Nuriye PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. , 2022, ss.661 - 670. 10.17343/sdutfd.1193868 |
| AMA | Erdoğan K,yılmaz n,ERDOĞAN A,sutcuoglu o,Yazıcı O,Ozdemir N PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. . 2022; 661 - 670. 10.17343/sdutfd.1193868 |
| Vancouver | Erdoğan K,yılmaz n,ERDOĞAN A,sutcuoglu o,Yazıcı O,Ozdemir N PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. . 2022; 661 - 670. 10.17343/sdutfd.1193868 |
| IEEE | Erdoğan K,yılmaz n,ERDOĞAN A,sutcuoglu o,Yazıcı O,Ozdemir N "PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS." , ss.661 - 670, 2022. 10.17343/sdutfd.1193868 |
| ISNAD | Erdoğan, Kübra vd. "PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS". (2022), 661-670. https://doi.org/10.17343/sdutfd.1193868 |
| APA | Erdoğan K, yılmaz n, ERDOĞAN A, sutcuoglu o, Yazıcı O, Ozdemir N (2022). PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, 29(4), 661 - 670. 10.17343/sdutfd.1193868 |
| Chicago | Erdoğan Kübra,yılmaz nisbet,ERDOĞAN AHMET,sutcuoglu osman,Yazıcı Ozan,Ozdemir Nuriye PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 29, no.4 (2022): 661 - 670. 10.17343/sdutfd.1193868 |
| MLA | Erdoğan Kübra,yılmaz nisbet,ERDOĞAN AHMET,sutcuoglu osman,Yazıcı Ozan,Ozdemir Nuriye PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, vol.29, no.4, 2022, ss.661 - 670. 10.17343/sdutfd.1193868 |
| AMA | Erdoğan K,yılmaz n,ERDOĞAN A,sutcuoglu o,Yazıcı O,Ozdemir N PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi. 2022; 29(4): 661 - 670. 10.17343/sdutfd.1193868 |
| Vancouver | Erdoğan K,yılmaz n,ERDOĞAN A,sutcuoglu o,Yazıcı O,Ozdemir N PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi. 2022; 29(4): 661 - 670. 10.17343/sdutfd.1193868 |
| IEEE | Erdoğan K,yılmaz n,ERDOĞAN A,sutcuoglu o,Yazıcı O,Ozdemir N "PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS." Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, 29, ss.661 - 670, 2022. 10.17343/sdutfd.1193868 |
| ISNAD | Erdoğan, Kübra vd. "PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS". Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 29/4 (2022), 661-670. https://doi.org/10.17343/sdutfd.1193868 |
