ReviewDiagnostic pathology2024
Lymph node ratio is a more robust predictor of overall survival than N stage in stage III colorectal adenocarcinoma.
Review in Diagnostic pathology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Proportional Nodal Burden as a Marker of Recurrence Risk in Non-Metastatic Colorectal Adenocarcinoma: The Prognostic Role of Lymph Node Ratio.Journal of clinical medicine · 2026Article
- The 12-node rule in irradiated rectal cancer: time for reappraisal?Journal of gastrointestinal oncology · 2026Article
- Prognostic and Predictive Value of Lymph Node Ratio in Stage III Colon Cancer in the Era of Molecular Biomarkers.Journal of the anus, rectum and colon · 2026Article
- Poor prognosis in stage III colorectal cancer with apical lymph node metastasis: a single-center retrospective study.Updates in surgery · 2025Article
- Comparison of LNR- and LODDS-based predictive models for prognosis in non-elderly patients with locally advanced rectal cancer undergoing neoadjuvant therapy.International journal of colorectal disease · 2025Article
- A prognostic nomogram utilized lymph node ratio for signet ring cell gastric cancer patients post-surgery.Journal of gastrointestinal oncology · 2025Article
- Development and validation of cancer-specific survival prediction nomogram for patients with T4 stage colon cancer after surgical resection: a population-based study.International journal of colorectal disease · 2025Article
- Lymph node yield does not affect the cancer-specific survival of patients with T1 colorectal cancer: a population-based retrospective study of the U.S. database and a Chinese registry.International journal of colorectal disease · 2025Article
- Prognostic value of metastatic lymph node ratio and its effect on disease-free survival in colon cancer.Frontiers in oncology · 2025Article
- Short-term outcomes of vessel-oriented D2 and D3 lymph node dissection for sigmoid colon cancer.Techniques in coloproctology · 2024Article
- Clinical Outcomes after Intracorporeal versus Extracorporeal Anastomosis in Patients Undergoing Laparoscopic Right Hemicolectomy for Colon Cancer.Medicina (Kaunas, Lithuania) · 2024Article
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Authors and funding
8 authors.
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Abstract
backgroundLymph node ratio (LNR) may offer superior prognostic stratification in colorectal adenocarcinoma compared with N stage. However, candidate cutoff ratios require validation. We aimed to study the prognostic significance of LNR and its optimal cutoff ratio.
methodsWe reviewed the pathology records of all patients with stage III colorectal adenocarcinoma who were managed at the King Hussein Cancer Center between January 2014 and December 2019. We then studied the clinical characteristics of the patients, correlates of lymph node count, prognostic significance of positive lymph nodes, and value of sampling additional lymph nodes.
resultsAmong 226 included patients, 94.2% had ≥ 12 lymph nodes sampled, while 5.8% had < 12 sampled lymph nodes. The median number of lymph nodes sampled varied according to tumor site, neoadjuvant therapy, and the grossing pathologist's level of training. According to the TNM system, 142 cases were N1 (62.8%) and 84 were N2 (37.2%). Survival distributions differed according to LNR at 10% (p = 0.022), and 16% (p < 0.001), but not the N stage (p = 0.065). Adjusted Cox-regression analyses demonstrated that both N stage and LNR at 10% and 16% predicted overall survival (p = 0.044, p = 0.010, and p = 0.001, respectively).
conclusionsLNR is a robust predictor of overall survival in patients with stage III colorectal adenocarcinoma. At a cutoff ratio of 0.10 and 0.16, LNR offers better prognostic stratification in comparison with N stage and is less susceptible to variation introduced by the number of lymph nodes sampled, which is influenced both by clinical variables and grossing technique.
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