The metastatic lymph node ratio predicts survival in colon cancer

Am J Surg. 2007 Dec;194(6):827-31; discussion 831-2. doi: 10.1016/j.amjsurg.2007.08.030.


Background: Lymph node metastases are the most important predictor of survival in non-stage IV colon cancer. Recent studies of gastric cancer have shown a prognostic significance of a lymph node ratio (number of positive nodes divided by total number harvested). Our goal was to determine whether a lymph node ratio (LNR) would predict disease-free survival (DFS) and overall survival (OS) in a tertiary care Veterans Affairs medical center.

Methods: A retrospective review of a prospectively collected database of colon cancer patients was performed to determine the effect of LNR on DFS and OS. A cohort of 232 patients with non-stage IV colon cancer was eligible for analysis. Survival curves were constructed using the Kaplan-Meier method.

Results: For all patients, a LNR of .08 was identified as a breakpoint for predicting OS and DFS. Specific analysis of stage III patients revealed that a LNR of .18 was predictive of DFS.

Conclusions: This study showed the prognostic significance of ratio-based staging for colon cancer and may aid in future staging systems.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colonic Neoplasms / mortality*
  • Colonic Neoplasms / pathology*
  • Disease-Free Survival
  • Female
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis / pathology*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Analysis