Abstract Background: The prognosis of colorectal cancer depends on the number of positive lymph nodes (LNþ) and the total number of lymph nodes resected (rLN). This represents the lymph-node ratio (LNR). The aim of our study is to assess how the length of the resected specimen (RL) influences the prognostic values of the LNR. Methods: We conducted a retrospective study of all the patients operated on for colorectal cancer from 2000 to 2015 at our institution. Pathology details were analysed. The total number of rLN, the number of LNþ, and the LNR were calculated and measured against the RL. The receiver-operating characteristic (ROC) curve of patients with LNþ was calculated. Results: Of the 670 patients included in our study, 337 were men (50.3%) and the mean age was 69.2 years. The correlation with prognosis of the LNR is greater than that of the LNR adjusted to RL (LNR/RL), both in subjects with positive nodes (n ¼ 312) and in all cases (n ¼ 670). The LNR presents a higher prognostic value than LNR/RL and RL in patients with LNþ except for metastatic recurrence, for which the predictive value appears slightly higher for LNR/RL. The statistical significance of the maximal divergence in Kaplan–Meier survival plots was demonstrated for the LNR (P ¼ 0.043), not for LNR/RL (P ¼ 0.373) and RL alone (P ¼ 0.314). Conclusion: An increase in RL causes an increase in the number of harvested lymph nodes without affecting the number of LNþ, thus representing a confounding factor that could alter the prognostic value of the LNR. Prospective larger-scale studies are needed to confirm these findings.

Is there a relationship between length of resection and lymph-node ratio in colorectal cancer?

Antonino Zanghi;Andrea Cavallaro;Emanuele Lo Menzo
;
Serena Curella;Salvatore Lo Bianco;Maria Di Vita;Francesco Cardi';Alessandro Cappellani.
2021-01-01

Abstract

Abstract Background: The prognosis of colorectal cancer depends on the number of positive lymph nodes (LNþ) and the total number of lymph nodes resected (rLN). This represents the lymph-node ratio (LNR). The aim of our study is to assess how the length of the resected specimen (RL) influences the prognostic values of the LNR. Methods: We conducted a retrospective study of all the patients operated on for colorectal cancer from 2000 to 2015 at our institution. Pathology details were analysed. The total number of rLN, the number of LNþ, and the LNR were calculated and measured against the RL. The receiver-operating characteristic (ROC) curve of patients with LNþ was calculated. Results: Of the 670 patients included in our study, 337 were men (50.3%) and the mean age was 69.2 years. The correlation with prognosis of the LNR is greater than that of the LNR adjusted to RL (LNR/RL), both in subjects with positive nodes (n ¼ 312) and in all cases (n ¼ 670). The LNR presents a higher prognostic value than LNR/RL and RL in patients with LNþ except for metastatic recurrence, for which the predictive value appears slightly higher for LNR/RL. The statistical significance of the maximal divergence in Kaplan–Meier survival plots was demonstrated for the LNR (P ¼ 0.043), not for LNR/RL (P ¼ 0.373) and RL alone (P ¼ 0.314). Conclusion: An increase in RL causes an increase in the number of harvested lymph nodes without affecting the number of LNþ, thus representing a confounding factor that could alter the prognostic value of the LNR. Prospective larger-scale studies are needed to confirm these findings.
2021
: colorectal cancer; lymph-node ratio; resection length; prognostic value
File in questo prodotto:
File Dimensione Formato  
goz066 gastroenterology report.pdf

accesso aperto

Tipologia: Versione Editoriale (PDF)
Dimensione 387.22 kB
Formato Adobe PDF
387.22 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/493040
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 3
social impact