Anticancer research · 2026
Prognostic Significance of the Lymph Node Ratio in Obstructive Colorectal Cancer: A Retrospective Multicenter Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Shiraishi Toshio, Tominaga Tetsuro, Nonaka Takashi, Takamura Yuma, Katayama Hiroki, Hashimoto Shintaro, Yamashita Mariko, Noda Keisuke, Motoyama Kazuki, Ono Rika, Hisanaga Makoto, Fukuda Akiko, Moriyama Masaaki, Uchida Fumitake, Kunizaki Masaki, Matsumoto Keitaro
Аннотация
BACKGROUND/AIM: This study evaluated the association between lymph node ratio (LNR) and long-term prognosis in pathological node-positive patients with obstructive colorectal cancer (CRC) who underwent colonic stent insertion as a bridge to surgery.
PATIENTS AND METHODS: This retrospective multicenter study included 75 node-positive patients with obstructive CRC treated with a colonic stent. Receiver operating characteristic analysis for 5-year relapse-free survival identified an optimal LNR cut-off of 0.125. Patients were thus classified into high-LNR (LNR-H, n=40) and low-LNR (LNR-L, n=35) groups. Clinicopathological factors, surgical outcomes, and survival were assessed.
RESULTS: The LNR-H group had a higher median number of metastatic lymph nodes (4 vs. 1; p<0.001), and a lower lymph node yield (21 vs. 27; p=0.022). LNR-H was associated with worse 5-year relapse-free survival (32.0% vs. 60.1%; p=0.012) and overall survival (51.2% vs. 72.7%; p=0.006). Multivariate analysis identified LNR-H (relapse-free survival: hazard ratio=2.371, 95% confidence interval=1.157-4.862; p=0.018; overall survival: hazard ratio=4.301, 95% confidence interval=1.595-11.569; p=0.004) and blood loss as independent predictors of prognosis.
CONCLUSION: LNR appears to represent a practical biomarker, with an elevated LNR independently predicting long-term outcomes among patients with node-positive obstructive CRC undergoing stent placement before surgery.
PATIENTS AND METHODS: This retrospective multicenter study included 75 node-positive patients with obstructive CRC treated with a colonic stent. Receiver operating characteristic analysis for 5-year relapse-free survival identified an optimal LNR cut-off of 0.125. Patients were thus classified into high-LNR (LNR-H, n=40) and low-LNR (LNR-L, n=35) groups. Clinicopathological factors, surgical outcomes, and survival were assessed.
RESULTS: The LNR-H group had a higher median number of metastatic lymph nodes (4 vs. 1; p<0.001), and a lower lymph node yield (21 vs. 27; p=0.022). LNR-H was associated with worse 5-year relapse-free survival (32.0% vs. 60.1%; p=0.012) and overall survival (51.2% vs. 72.7%; p=0.006). Multivariate analysis identified LNR-H (relapse-free survival: hazard ratio=2.371, 95% confidence interval=1.157-4.862; p=0.018; overall survival: hazard ratio=4.301, 95% confidence interval=1.595-11.569; p=0.004) and blood loss as independent predictors of prognosis.
CONCLUSION: LNR appears to represent a practical biomarker, with an elevated LNR independently predicting long-term outcomes among patients with node-positive obstructive CRC undergoing stent placement before surgery.