title: The metastatic lymph node ratio predicts survival in colon cancer.
abstract: BACKGROUND
  Lymph node metastases are the most important predictor of survival in non-stage IV colon cancer. Recent studies of gastric cancer have shown a prognostic significance of a lymph node ratio (number of positive nodes divided by total number harvested). Our goal was to determine whether a lymph node ratio (LNR) would predict disease-free survival (DFS) and overall survival (OS) in a tertiary care Veterans Affairs medical center.
  
  
  METHODS
  A retrospective review of a prospectively collected database of colon cancer patients was performed to determine the effect of LNR on DFS and OS. A cohort of 232 patients with non-stage IV colon cancer was eligible for analysis. Survival curves were constructed using the Kaplan-Meier method.
  
  
  RESULTS
  For all patients, a LNR of .08 was identified as a breakpoint for predicting OS and DFS. Specific analysis of stage III patients revealed that a LNR of .18 was predictive of DFS.
  
  
  CONCLUSIONS
  This study showed the prognostic significance of ratio-based staging for colon cancer and may aid in future staging systems.
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, MC-9155, Dallas, TX 75390-9155, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Schumacher
authors.forename: Sean
authors.initials: S
authors.lastname: Dineen
authors.forename: Carlton
authors.initials: C
authors.lastname: Barnett
authors.forename: Jason
authors.initials: J
authors.lastname: Fleming
authors.forename: Thomas
authors.initials: T
authors.lastname: Anthony
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000401:mortality* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis