title: Importance of metastatic lymph node ratio in non-metastatic, lymph node-invaded colon cancer: a clinical trial.
abstract: BACKGROUND
  The aim of this study was to evaluate the prognostic importance of the metastatic lymph node ratio for stage III colon cancer patients and to find a cut-off value at which the overall survival and disease-free survival change.
  
  
  METHODS
  Patients with pathological stage III colon cancer were retrospectively evaluated for: age; preoperative values of Crp, Cea, Ca 19-9, and Afp; pathologic situation of vascular, perineural, lymphatic, and serosal involvement; and metastatic lymph node ratio values were calculated.
  
  
  RESULTS
  The study included 58 stage III colon cancer patients: 20 (34.5%) females and 38 (65.5%) males were involved in the study. Multivariate analysis was applied to the following variables to evaluate significance for overall survival and disease-free survival: age, Crp, Cea, perineural invasion, and metastatic lymph node ratio. The metastatic lymph node ratio (<0.25 or ≥0.25) is the only independent variable significant for overall and disease-free survival.
  
  
  CONCLUSIONS
  Metastatic lymph node ratio is an ideal prognostic marker for stage III colon cancer patients, and 0.25 is the cut-off value for prognosis.
authors.affiliation: Department of General Surgery, Erzincan University, Erzincan, Turkey.
authors.forename: Arda
authors.initials: A
authors.lastname: Isik
authors.affiliation: Department of General Surgery, Erzincan University, Erzincan, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Peker
authors.affiliation: Department of General Surgery, Erzincan University, Erzincan, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Firat
authors.affiliation: Department of General Surgery, Duzce State Hospital, Duzce, Turkey.
authors.forename: Bahri
authors.initials: B
authors.lastname: Yilmaz
authors.affiliation: Department of Pathology, Erzincan University, Erzincan, Turkey.
authors.forename: Ilyas
authors.initials: I
authors.lastname: Sayar
authors.affiliation: Department of General Surgery, Yunak State Hospital, Konya, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Idiz
authors.affiliation: Department of General Surgery, Avicenna Hospital, Istanbul, Turkey.
authors.forename: Coskun
authors.initials: C
authors.lastname: Cakir
authors.affiliation: Department of General Surgery, Erzincan University, Erzincan, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Demiryilmaz
authors.affiliation: Department of General Surgery, Erzincan University, Erzincan, Turkey.
authors.forename: Ismayil
authors.initials: I
authors.lastname: Yilmaz
mesh_terms: D000367:Age Factors; D014408:Biomarkers, Tumor; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000503:physiopathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor
references.citation: J Surg Oncol. 2009 Sep 1;100(3):240-3
references.pmid: 19330780
references.citation: Dis Colon Rectum. 2009 Jul;52(7):1244-50
references.pmid: 19571700
references.citation: Arch Pathol Lab Med. 2000 Jul;124(7):958-65
references.pmid: 10888771
references.citation: Int J Colorectal Dis. 2009 Nov;24(11):1297-302
references.pmid: 19479270
references.citation: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references.pmid: 21296855
references.citation: J Gastrointest Cancer. 2014 Jun;45(2):133-6
references.pmid: 24382601
references.citation: Am Surg. 2004 Mar;70(3):235-40; discussion 240
references.pmid: 15055847
references.citation: Lancet. 2010 Mar 20;375(9719):1030-47
references.pmid: 20304247
references.citation: Ann Surg. 2011 Jan;253(1):82-7
references.pmid: 21135690
references.citation: Med Sci Monit. 2013 Mar 20;19:203-9
references.pmid: 23511310
references.citation: Eur J Surg Oncol. 2002 Aug;28(5):481-9
references.pmid: 12217299
references.citation: N Engl J Med. 1985 Jun 20;312(25):1604-8
references.pmid: 4000199
references.citation: Ann Neurol. 2008 Oct;64(4):428-33
references.pmid: 18688811
references.citation: Med Sci Monit. 2012 Jul;18(7):BR273-80
references.pmid: 22739727
references.citation: Am J Surg. 2007 Dec;194(6):827-31; discussion 831-2
references.pmid: 18005779
references.citation: Ann Surg Oncol. 2002 Oct;9(8):775-84
references.pmid: 12374661
references.citation: J Natl Cancer Inst. 2001 Apr 18;93(8):583-96
references.pmid: 11309435
references.citation: Eur J Surg Oncol. 2005 Feb;31(1):59-66
references.pmid: 15642427