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. 2009 May 19;100(10):1530-3.
doi: 10.1038/sj.bjc.6605049. Epub 2009 Apr 28.

Positive lymph node retrieval ratio optimises patient staging in colorectal cancer

S J Moug  1 , J D Saldanha, J R McGregor, M Balsitis, R H Diament
Affiliations

Positive lymph node retrieval ratio optimises patient staging in colorectal cancer

S J Moug et al. Br J Cancer. .

Abstract

Alternative lymph node (LN) parameters have been proposed to improve staging in colorectal cancer. This study compared these alternative parameters with conventional TNM staging in predicting long-term survival in patients undergoing curative resection. A total of 295 consecutive patients (mean age 70 years; range 39-95; s.d. 10.4) underwent resection for colorectal cancer from 2001 to 2004. Age, sex, primary tumour site, TNM stage and chemotherapy/radiotherapy were recorded. Patients with colon and rectal cancers were analysed separately for LN parameters: LN total; adequate LN retrieval (> or =12) and inadequate (<12); total number of negative LN; total number of positive LN and the ratio of positive LN to total LN (pLNR). Univariate and multivariate survival analysis was performed. The median number of LN retrieved was 10 (1-57) with adequate LN retrieval in 147 cases (49.8%). For each T and N stage, inadequate LN retrieval did not adversely affect long-term survival (P>0.05). On multivariate analysis, only pLNR was an independent predictor of overall survival in both colon and rectal cancers (HR 11.65, 95% CI 5.00-27.15, P<0.001 and HR 13.40, 95% CI 3.64-49.10, P<0.001, respectively). Application of pLNR subdivided patients into four prognostic groups. Application of the pLNR improved patient stratification in colorectal cancer and should be considered in future staging systems.

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Figures

Figure 1
Figure 1
Differences in overall survival in patients undergoing curative resection for colon cancer when classified by positive lymph node ratios.
Figure 2
Figure 2
Differences in overall survival in patients undergoing curative resection for rectal cancer when classified by positive lymph node ratios.
See this image and copyright information in PMC

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