The impact of lymph node ratio (LNR) on survival in colorectal cancer: a retrospective cohort study

Year 2026, Volume: 7 Issue: 1, 108 - 113, 20.02.2026

Hüseyin Kocaaslan , Fatih Sümer

https://izlik.org/JA75FX57GY

Abstract

Aims: This study aimed to investigate the prognostic value of the lymph node ratio (LNR) on survival in patients with colorectal cancer.
Methods: After excluding patients with metastatic disease and those who underwent palliative surgery, a total of 211 patients who underwent curative surgical resection for colorectal cancer between 2013 and 2022 were retrospectively analyzed. LNR was calculated as the ratio of the number of metastatic lymph nodes to the total number of lymph nodes examined. Patients were stratified into four groups according to their LNR values: LNR=0, 00.2. Survival analyses were performed using the Kaplan–Meier method and Cox proportional hazards regression models.
Results: Of the patients, 124 (59.0%) were male. The mean follow-up duration was 38.2±41.1 months. The mean number of harvested lymph nodes was 32.4±27.1, and the mean number of positive lymph nodes was 3.2±5.8. According to LNR classification, 132 patients (62.9%) had LNR=0, 38 (18.1%) had 00.2. In univariate Cox regression analysis, using LNR=0 as the reference category, the hazard ratio (HR) was 2.45 (95% CI: 1.32–4.55, p=0.004) for 00.2.
Conclusion: LNR is a strong and independent predictor of survival in patients with colorectal cancer. Incorporating LNR into clinical practice may improve risk stratification and facilitate personalized treatment strategies.

Keywords

Colorectal cancer , lymph node ratio , prognosis

Ethical Statement

Ethical Declarations Ethics Committee Approval: This study was approved by the Inonu University Health Sciences Scientific Research Ethics Committee (Protocol No: 2025/8829). All patient data were anonymized in accordance with confidentiality rules. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Informed Consent: Because the study was designed retrospectively, no written informed consent form was obtained from patients. Referee Evaluation Process: Externally peer-reviewed. Conflict of Interest Statement: The authors declare that they have no competing interests. Financial Disclosure: The authors declared that this study received no financial support. Author Contributions: All of the authors declare that they have all participated in the design, execution, and analysis of the paper, and they approved the final version.

Supporting Institution

No funding

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