Impact of the log odds of positive lymph nodes on the prognosis in pathological stage 3 patients with obstructive colorectal cancer treated with colonic stents: a retrospective multicenter study in Japan.

PURPOSE: This study investigated the relationship between log odds of positive lymph nodes (LODDS) and the long-term prognosis in pathological stage 3 obstructive colorectal cancer (CRC) patients who underwent self-expandable metal stent (SEMS) insertion as a bridge to surgery (BTS).

METHODS

This retrospective multicenter study included 75 patients with stage 3 CRC. The patients were classified into high-LODDS (LODDS-H, n = 32) and low-LODDS (LODDS-L, n = 43) groups.

RESULTS

Significant differences were found in the 5-year relapse-free survival (RFS) rates (LODDS-H: 34.0% vs. LODDS-L: 53.1%; p = 0.041) and overall survival (OS) rates (52.4% vs. 68.3%; p = 0.012). A multivariate analysis revealed that blood loss [hazard ratio (HR) 2.266, 95% confidence interval (CI), 1.142-4.494; p = 0.019] was an independent predictor of the RFS. Age ≥ 75 years old (HR 2.769, 95% CI 1.206-6.360; p = 0.016), blood loss (HR 3.552, 95% CI 1.460-8.643; p = 0.005), adjuvant chemotherapy (HR 0.415, 95% CI 0.177-0.972; p = 0.043), and LODDS (HR 3.593, 95% CI 1.511-8.544; p = 0.004) were independent predictors of OS.

CONCLUSIONS

The LODDS appears to be prognostically accurate for patients with stage 3 obstructive CRC undergoing BTS. Incorporating the LODDS into clinical evaluations may enable more accurate prognostic stratification.