Abstract
Objectives:To investigate the prognostic significant of lymph node ratio and surgical margins in patients with colon cancer undergoing surgery.Methods:This observational and retrospective study was conducted at Karadeniz Technical University Medical Faculty, between 1 January, 2010 and 31 November, 2020. A series of 137 patients who had undergone surgical resection of colon carcinoma were included in this study. mLNR, defined as the ratio of the number of mLNs to the number of examined lymph nodes, was calculated in colorectal cancer cases with lymph node metastasis. Patients were divided into three groups; LNR1 (< 0.25), LNR2 (0.25-0.6) and LNR3 (> 0.6).Results:Mean disease-free survival was 79.2 months (95% CI 71.0-87.4). The mean expected survival time was 73.5 months (95% CI: 65.9-81.0). As the metastatic LN ratio increased, the rate of local recurrence or distant metastasis increased statistically significantly (p=0.007). As the metastatic LN ratio increased, the death rate increased statistically significantly (p=0.036). Metastatic lymph node ratio did not have a statistically significant effect on overall survival in patients with stage-3 and more than 12 LNs removed (p=0.069). There was no statistically significant association between the closeness of the surgical margin and disease-free survival in stage 1 (p=0.505) and stage-2 (p=0.161). There was no statistically significant association between the closeness of the surgical margin and overall survival among patients with stage 1 (p=0.494) and stage 2 (p=0.265).Conclusion:A high metastatic LNR is associated with poorer overall and disease-free survival.
Highlights
Colon cancer is one of the most common cancer in women and men, and represents approximately 1/3 of gastrointestinal system cancers.[1]
Lymph node involvement is associated with the prognosis of the disease and is one of the risk factors employed in the planning of adjuvant therapy[2]
Mean disease-free survival was 79.2 months. 1-year, 3-year and 5- year disease- free survival rates of the cases were 86.3%, 72.5% and 70.3%, respectively
Summary
Colon cancer is one of the most common cancer in women and men, and represents approximately 1/3 of gastrointestinal system cancers.[1] Lymph node involvement is associated with the prognosis of the disease and is one of the risk factors employed in the planning of adjuvant therapy[2]. Regional lymph nodes (pN) are classified solely on the basis of the number of lymph nodes involved. If lymph node involvement is present and there is no distant metastasis, patients are classified as. Current guidelines state that 12 lymph nodes are sufficient for the assessment of lymph node involvement.[3,4] insufficient lymph node removal can lead to pN-related problems and to difficulties in determining prognosis and treatment planning.[5]
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