SP3.1.4 Benign Lymph Node Ratio (LNR) and Lymph Node Yield (LNY) as predictors of survival in resected colorectal cancer (CRC). (9th August 2022)

• Record Type: Journal Article
• Authors: Issa, Mohamed; Ahmad, Salma; Wilson, Jeremy; Magee, Conor
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 5
• Publication Date: 2022-08-09
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac247.032
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: Lymphadenectomy is central to tumor prognosis. 12 LNY during CRC resection is a standard of good oncological resection, but 30–50 percent of resections do not achieve this. LNR was suggested to be a more accurate predictive factor. Aim: To examine the prognostic significance of LNY and LNR on survival in patients with non-metastatic CRC. Methods: A retrospective study on patients with CRC treated at a DGH from January 2015 to February 2017. Outcome measures were Disease-Free (DFS) and Overall Survival (OS). Results: 265 cases were identified. The mean age was (71.4±11.3) years with a median follow-up of 56 (range 0–72) months. Median LNY was 18 (range 0–66) nodes. 74.9% of the cases have> 12 LNY and only 25.1% of the cases have < 12 LN yielded in the specimen; however, 76.4% have LNR of 0-<0.25. Increasing LNR was associated with poorer OS and DFS (p-value 0.0001). An LNR of (0.75–1) was associated with a very poor prognosis (p-value 0.0001); it showed 30 and 33 months less in median OS and DFS retrospectively than LNR (0-<0.25). LNY did not show any statistically significant predictive factor in survival. Multivariate analysis showed OS and DFS are affected (R2= 27.3% and 26.1% retrospectively) mainly by LNR. It did not show statistical significance with the other variables, including TNM, LNY, and Dukes' stages. Conclusion: Increasing LNR was a marker of poor survival; however, LNY was not a statistically significant predictive factor. LNR is better in predicting survival than TNM and Dukes' staging.