Novel lymph node ratio predicts prognosis of colorectal cancer patients after radical surgery when tumor deposits are counted as positive lymph nodes: a retrospective multicenter study
机构:[1]Central Laboratory, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, China[2]General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, China[3]Department of General Surgery, Zhongshan Hospital, Fudan University Colorectal Cancer Research Center, Shanghai, China[4]General Surgery Department, Sichuan Cancer Hospital, Chengdu, China四川省肿瘤医院[5]Gastrointestinal Tumor Surgery Department, Hubei Cancer Hospital, Wuhan, China[6]General Surgery Department, 2nd Affiliated Hospital of Jilin University, Changchun, China[7]Internal Medicine-Oncology, Cancer Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China[8]General Surgery Department, Xuzhou Central Hospital, Xuzhou, China[9]Surgical Department of Gastrointestinal Diseases, Youan Hospital of Capital Medical University, Beijing, China[10]Department of Pathology, Clinical Medical College of Chengdu University, Chengdu, China
The lymph node ratio (LNR), defined as the relation of tumor-infiltrated to resected lymph nodes, has been identified as an independent prognostic factor for colorectal cancer (CRC) after radical surgery. Recently, new guidelines propose counting tumor deposits (TDs) as positive lymph nodes (pLNs). The aim of this study was to investigate whether a novel LNR (nLNR) that considers TDs as pLNs can be used to accurately predict the long-term outcome of CRC patients. In this multicenter retrospective study, clinicopathological and outcome data from 2,051 stage III CRC patients who underwent R0 resection were collected between January 2004 and December 2011. Disease-free survival (DFS) and overall survival (OS) according to the nLNR category were analyzed using Kaplan-Meier survival curves. Univariate and multivariate analyses were performed to determine significant prognostic factors, and ROC curves were computed to measure the predictive capacity of the nLNR category. The 5-year DFS rates of nLNR1-4 were 68.3%, 48.4%, 33.3% and 16.5%, respectively (P<0.0001), and the 5-year OS rate of nLNR1-4 were 71.8%, 60.1%, 42.7% and 21.8%, respectively (P<0.0001). The area of under curve (AUC) of the nLNR was 0.686 (95% CI 0.663-0.710) and 0.672 (95% CI 0.648-0.697) for predicting DFS and OS. Our results demonstrate that the nLNR predicted long-term outcomes better than the LNR, npN and pN, using the cutoff points 0.250, 0.500 and 0.750.
基金:
Scientific Research Project of Clinical Medical College of Chengdu University [201509]; Project of Sichuan Provincial Department of Health [090112]
第一作者机构:[1]Central Laboratory, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, China
共同第一作者:
通讯作者:
通讯机构:[2]General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, China[3]Department of General Surgery, Zhongshan Hospital, Fudan University Colorectal Cancer Research Center, Shanghai, China
推荐引用方式(GB/T 7714):
Yang Jin,Xing Shasha,Li Jun,et al.Novel lymph node ratio predicts prognosis of colorectal cancer patients after radical surgery when tumor deposits are counted as positive lymph nodes: a retrospective multicenter study[J].ONCOTARGET.2016,7(45):73865-73875.doi:10.18632/oncotarget.12076.
APA:
Yang, Jin,Xing, Shasha,Li, Jun,Yang, Shengke,Hu, Junjie...&Lv, Bo.(2016).Novel lymph node ratio predicts prognosis of colorectal cancer patients after radical surgery when tumor deposits are counted as positive lymph nodes: a retrospective multicenter study.ONCOTARGET,7,(45)
MLA:
Yang, Jin,et al."Novel lymph node ratio predicts prognosis of colorectal cancer patients after radical surgery when tumor deposits are counted as positive lymph nodes: a retrospective multicenter study".ONCOTARGET 7..45(2016):73865-73875