Prognostic value of PLN, LNR, and LODDS in advanced colorectal signet ring cell carcinoma.

OBJECTIVE

This study aimed to evaluate the prognostic value of positive lymph node (PLN), lymph node ratio (LNR) and the log odds of metastatic lymph nodes (LODDS) in advanced colorectal signet ring cell carcinoma (CRC-SRCC) patients.

METHODS

CRC-SRCC patients were collected from the SEER database between 2013 and 2017 to form the training set. Concurrently, patients from four tertiary hospitals in China were gathered to constitute an external validation set. Survival curves were constructed using the Kaplan-Meier method, and univariate and multivariate prognostic analyses were conducted using the Cox proportional hazards model. A nomogram model was developed, and the discrimination and accuracy of the model were assessed using calibration curves, and receiver operating characteristic (ROC) curves.

RESULTS

A total of 391 patients with advanced CRC-SRCC were included in the study. Univariate and multivariate analyses demonstrated that high PLN, LNR, and LODDS were significantly associated with worse cancer-specific survival (CSS) and overall survival (OS). Combined variable of PLN, LNR, and LODDS had greater prognostic value, compared with the triple-variable low group, the triple-variable high group had a 7.398-fold (95% CI: 3.488-15.691) increased risk of death. Further analysis showed that the combined variable contributed 54.7% to prognosis in the training set and 47.6% in the validation set. A prognostic nomogram incorporating the combined variable was developed. The calibration curve and ROC curve indicated that the model had relatively good predictive accuracy.

CONCLUSION

PLN, LNR, and LODDS may serve as valuable indicators for prognostic assessment in patients with CRC-SRCC, with the combined variable demonstrating superior predictive performance.