ArticleWorld journal of surgery2009
The lymph node ratio is a powerful prognostic factor of node-positive colon cancers undergoing potentially curative surgery.
Article in World journal of surgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic role of the lymph node ratio in node positive colorectal cancer: a meta-analysis.Oncotarget · 2016Pooled it
- Association of lymph node ratio with perioperative outcomes and survival in patients with early-onset gastric cancer: a multicenter retrospective cohort study.Updates in surgery · 2026Article
- Analysis of the predictive postoperative recurrence performance of three lymph node staging systems in patients with colon cancer.Frontiers in oncology · 2025Article
- The effect of lymph node ratio on the surgical outcomes in patients with colorectal cancer.Scientific reports · 2024Article
- Chemokine- and chemokine receptor-based signature predicts immunotherapy response in female colorectal adenocarcinoma patients.Scientific reports · 2023Article
- New Personal Model for Forecasting the Outcome of Patients with Histological Grade III-IV Colorectal Cancer Based on Regional Lymph Nodes.Journal of oncology · 2023Article
- A retrospective study analyzing if lymph node ratio carbon nanoparticles predict stage III rectal cancer recurrence.Frontiers in oncology · 2023Article
- Log odds of positive lymph nodes is prognostically equivalent to lymph node ratio in non-metastatic colon cancer.BMC cancer · 2020Article
- Metastatic lymph node ratio as a prognostic indicator in patients with stage IV colon cancer undergoing resection.Journal of Cancer · 2019Article
- Prognostic significance of lymph node ratio in patients with Merkel cell carcinoma.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2015Article
- CD26-positive/CD326-negative circulating cancer cells as prognostic markers for colorectal cancer recurrence.Oncology letters · 2015Article
- Prognostic Value of Lymph Node Ratio in Comparison to Lymph Node Metastases in Stage III Colon Cancer.Iranian journal of pathology · 2015Article
- The prognostic value of lymph node ratio and updated TNM classification in rectal cancer patients with adequate versus inadequate lymph node dissection.Techniques in coloproctology · 2014Article
- Is complete mesocolic excision with central vascular ligation safe and effective in the surgical treatment of right-sided colon cancers? A prospective study.International journal of colorectal disease · 2014Observational
- Postoperative detection of circulating tumor cells predicts tumor recurrence in colorectal cancer patients.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2013Article
- Proposal of a new classification for stage III colorectal cancer based on the number and ratio of metastatic lymph nodes.World journal of surgery · 2013Article
- The role and prognostic impact of lymph node ratio on stage III colorectal cancer.Clujul medical (1957) · 2013Article
- Evaluation of lymph nodes in patients with colon cancer undergoing colon resection: a population-based study.World journal of surgery · 2012Article
- Prognostic value of the lymph node ratio in stage III colorectal cancer.Chinese journal of cancer · 2012Article
- Dukes C colorectal cancer: is the metastatic lymph node ratio important?International journal of colorectal disease · 2012Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe number of harvested (LNs) and metastatic nodes (LNs+) represents the most significant factor to define postoperative treatment and prognosis in colon cancer. However, its assessment may be inadequate causing an incorrect cancer staging. The lymph node ratio (LNR: the ratio between metastatic and resected nodes) has shown prognostic significance in many tumors; however, its role in colon cancer is not clearly elucidated. This study investigated LNR as a prognostic factor in node-positive colon cancers.
methodsA total of 145 consecutive patients with node-positive colon cancer who underwent curative surgery and adjuvant chemotherapy in a single oncologic unit entered this study.
resultsLNR ranged from 0.0416 to 0.9; it was clearly lower in pN1 than pN2 patients, and increased as tumor stage worsened. ROC analysis selected 0.1818 as the best LNR cutoff value. Low LNR patients did significantly better than high LNR patients; this difference was not dependent on the number of LNs and stronger than differences observed by grouping patients according to LNs or LNs+. When stratified by low and high LNR value, pN1 and pN2 patients, as well as stage III subgroups were shown to display substantially different outcomes. LNR was an independent prognostic factor for disease-specific survival, and the only covariate related to disease-free survival.
conclusionsLNR was a robust prognostic indicator for node-positive colon cancers undergoing curative surgery. Because this ratio-based staging was demonstrated to reduce stage migration and to aid in identifying high-risk patients, it should be proposed as a standard tool for colon cancer staging.
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