gms | German Medical Science

130. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

30.04. - 03.05.2013, München

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Impact of Lymph Node Count versus Lymph Node Ratio on Survival Analysis in UICC Stage III Colorectal Cancer

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  • Tarkan Jäger - Paracelsus Medical University, Department of Surgery, Salzburg
  • Florian Primavesi - Paracelsus Medical University, Department of Surgery, Salzburg
  • Adam Dinnewitzer - Paracelsus Medical University, Department of Surgery, Salzburg
  • Clemens Nawara - Paracelsus Medical University, Department of Surgery, Salzburg
  • Dietmar Öfner - Paracelsus Medical University, Department of Surgery, Salzburg

Deutsche Gesellschaft für Chirurgie. 130. Kongress der Deutschen Gesellschaft für Chirurgie. München, 30.04.-03.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13dgch032

doi: 10.3205/13dgch032, urn:nbn:de:0183-13dgch0328

Veröffentlicht: 26. April 2013

© 2013 Jäger et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

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Introduction: Lymph node status is an important prognostic factor in curative oncologic colorectal surgery. An inadequate number of lymph nodes may result in under-staging with consequences on therapeutic and prognostic effects. The aim of our study was to evaluate the impact of total lymph node count (LNC) in comparison to the lymph node ratio (LNR) on overall (OAS) and disease specific survival (DSS) in UICC stage III colorectal cancer.

Material and methods: Data were collected prospectively within a proprietary colorectal cancer database. The cutoff point of LNC was chosen as 12 because of current guidelines recommendation to assess a minimum of 12 lymph nodes in colorectal surgery. The cutoff point of LNR was chosen as 0.15 because of significant survival difference at that LNR.

Results: Of the 185 UICC stage III patients with colorectal cancer, 115 (62%) were localized in the colon and 70 (38%) in the rectum. Five-year OAS and DSS for all patients: Group 1: LNC Cutoff 12: OAS: LNC < 11 = 56%, LNC ≥ 12 = 80%, (P = 0.06) and DSS: LNC < 11 = 64%, LNC ≥ 12 = 87%, (P = 0.07). Group 2: LNR Cutoff 0.15: OAS: LNR ≤ 0.15 = 86%, LNR > 0.15 = 67%, (P = 0.08) and DSS: LNR ≤ 0.15 (P = 0.03).

Conclusion: After investigation of the colon and rectal cohort separately: LNC revealed as a statistically significant predictor in OAS and DSS in colon cancer. LNR was identified as a predictor in colon cancer for OAS. Within the rectal cohort no statistically significant difference for OAS and DSS occurred.