title: Metastatic lymph node ratio is a more precise predictor of prognosis than number of lymph node metastases in stage III colon cancer.
abstract: OBJECTIVE
  The objective of this study is to assess the value of metastatic lymph node ratio (LNR) in predicting disease-free survival (DFS) in patients with stage III adenocarcinoma of the colon.
  
  
  METHODS
  From 1995 to 2003 inclusively, a total of 624 patients featuring stage III adenocarcinoma of the colon underwent curative resection. Of the 624 patients, an adequate number of lymph nodes (n > or = 12) had been harvested in 490 patients. These patients were stratified into LNR groups 1 (LNR < or = 0.4), 2 (0.4 < LNR < or = 0.7), and 3 (LNR > 0.7). Kaplan-Meier survival curve and log-rank test were used to evaluate the prognostic value of LNR. A Cox regression model was used for multivariate analyses.
  
  
  RESULTS
  The 5-year DFS rate was 66.7% for patients with LNR1, 35.1% for those with LNR2, and 0% for patients with LNR3 (p < 0.0001). In T3/4LNR1 patients (n = 411), there was no difference in survival between those with N1 stage and those with N2 stage. Cox proportional hazards regression analysis revealed that N stage (number of positive lymph nodes) was not a significant factor when LNR was taken into consideration.
  
  
  CONCLUSIONS
  LNR is a more precise predictor of 5-year DFS than number of positive lymph nodes (N stage) in patients with stage III colon cancer.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, 6 West, Chia-Pu Road, Putz City, Chiayi County, Taiwan.
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Chin
authors.forename: Jeng-Yi
authors.initials: JY
authors.lastname: Wang
authors.forename: Chien-Yuh
authors.initials: CY
authors.lastname: Yeh
authors.forename: Yi-Hung
authors.initials: YH
authors.lastname: Kuo
authors.forename: Wen-Shih
authors.initials: WS
authors.lastname: Huang
authors.forename: Chung-Hung
authors.initials: CH
authors.lastname: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D055815:Young Adult