ArticleCancer management and research2025
Advancing Prognostic Accuracy Beyond Classical N Staging in Colorectal Cancer: An Observational Cohort Study to Define a Lymph Node Ratio Based Risk Score.
Article in Cancer management and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The impact of age on survival in stage II colon cancer: a SEER database analysis stratified by chemotherapy status.Translational cancer research · 2026Article
- Prognostic value of lymphovascular invasion and CEA for cancer-specific survival in octogenarian colorectal cancer patients.World journal of surgical oncology · 2026Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Lymph node involvement is critical for colorectal cancer (CRC) staging and prognosis. The lymph node ratio (LNR), defined as the ratio of metastatic to total examined lymph nodes, has shown promise as a superior prognostic metric compared to traditional TNM staging and total lymph node yield (LNY). This study compared the prognostic value of LNR, N staging, and LNY and developed an LNR-based survival risk score (LNR-SRS Patients and Methods: A population-based cohort of 2013 CRC cases (2013-2018) from the Reggio Emilia Cancer Registry was analyzed. Prognostic models, including T-LNR-M, TNM, and T-LNY-M, were compared using Harrell's C-index, Akaike Information Criterion (AIC), and net reclassification improvement (NRI). Patients were randomly assigned to training (1026) and validation (987) cohorts. Multivariable analysis identified significant predictors, and a survival risk score (SRS Results: The T-LNR-M model outperformed TNM (C-index 71% vs 70%; NRI 4.7%, P = 0.002) and T-LNY-M (C-index 71% vs 70%) with the lowest AIC (8356). Predictors of mortality included T4 stage, LNR, metastasis, and age >78.6 years. LNR-SRS Conclusion: LNR provides superior prognostic value compared to N staging or LNY. The LNR-SRS
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