PROGNOSTIC IMPORTANCE OF THE LYMPH NODE RATIO IN STAGE III COLORECTAL CANCERS

Öz

Objective Colorectal cancers (CRCs) are among the most com- mon cancers all over the world with a high mortality rate. Many prognostic factors have been identified for these cancers, one of which is the lymph node ratio (LNR). The purpose of this study was to reveal the prognostic importance of the LNR in stage III CRCs. Material and Method The records of stage III colorectal patients who received adjuvant chemotherapy between January 1998 and May 2014 were examined retrospectively. Similar to the literature, the patients were divided into three groups according to their LNRs. Those with a ratio of 0–0.20 were in the 1st group, with 0.21–0.50 were in the 2nd group, and with 0.51–1 were in the 3rd group. Demographic characteristics of the patients, number of positive and total lymph nodes removed, lymph node positivity rate, presence of free tumor nodules, and survival were evaluated. Results A total of 263 patients were included in the study. While 163 (61.9%) of the patients were male, the median age was 62 (min: 25–max: 85). The mean number of lymph nodes removed was 17.46 (±11.55), and the mean number of positive lymph nodes was 3.48 (±5.13). The mean duration of disease-free survival (DFS) was 65.2 (±46.07) months (min = 6, max = 223). The mean overall survival time (OS) was 70.9 (±44.4) months (min = 6, max = 223). In univariate analysis, it was observed that as the LNR increased, recurrence and mortality increased statistically significantly (P < 0.001). According to the results of multivariate analysis, the relationship of DFS and OS with the LNR groups was statistically significant (P = 0.030 and P = 0.019, respectively). Conclusion The LNR in operated stage III CRC is an effective prognostic factor on DFS and OS.

Anahtar Kelimeler

• Colorectal cancer
• Prognosis
• Lymph node ratio
• Adjuvant chemotherapy

EVRE III KOLOREKTAL KANSERLERDE LENF NODU POZİTİFLİK ORANININ PROGNOSTİK ÖNEMİ

Öz

Amaç Kolorektal kanserler, tüm dünyada sık görülen ve mortalitesi yüksek kanserlerdendir. Bu kanserler ile ilgili birçok prognostik faktör tanımlanmıştır. Bunlardan bir tanesi de lenf nodu pozitiflik oranıdır. Bu çalışmanın amacı, Evre III kolorektal kanserlerde lenf nodu pozitiflik oranının prognostik önemini ortaya koymaktır. Gereç ve Yöntem Ocak 1998 ile Mayıs 2014 tarihleri arasında kolorektal kanser tanısı ile opere edilip adjuvan kemoterapi alan, evre III hastaların kayıtları retrospektif olarak incelendi. Hastalar literatüre benzer şekilde lenf nodu pozitiflik oranına göre 0-0,20 arası olanlar 1. grup, 0,21-0,50 arası olanlar 2. grup ve 0,51-1 arası olanlar 3. grup şeklinde üç gruba ayrıldı. Hastaların demografik özellikleri, çıkarılan pozitif ve toplam lenf nodu sayısı, lenf nodu pozitiflik oranı, serbest tümör nodülü varlığı ve sağ kalım verileri incelendi. Bulgular Çalışmaya 263 hasta dâhil edildi. Hastaların 163’ü (%61,9) erkek iken, yaş ortanca değeri 62 (min: 25-max:85) idi. Ortalama çıkarılan lenf nodu sayısı 17.46 (±11.55) ve ortalama pozitif lenf nodu sayısı 3.48 (±5.13) idi. Hastalıksız sağkalım süresi ortalama 65,2(±46,07) ay (min=6, max=223) idi. Genel sağkalım süresi ortalama 70,9 (±44,4) ay (min=6, max=223) idi. Hastalıksız sağkalım ve genel sağkalım ile lenf nodu grupları arasındaki ilişki tek değişkenli analizde incelendiğinde; lenf nodu pozitiflik oranını arttıkça nüksün ve mortalitenin istatistiksel olarak anlamlı şekilde arttığı gözlendi (p<0,001). Çok değişkenli analiz sonuçlarına göre de hastalıksız sağkalım ve genel sağkalım ile lenf nodu pozitiflik oranını grupları arasındaki ilişki [sırasıyla (p=0,030), (p=0,019)] istatistiksel olarak anlamlı bulundu. Sonuç Opere evre III kolorektal kanserlerde lenf nodu pozitiflik oranın hastalıksız sağ kalım ve genel sağ kalım üzerine, etkili bir prognostik faktördür.

Anahtar Kelimeler

• Kolorektal kanser
• Prognoz
• Lenf nodu oranı
• Adjuvan kemoterapi

Kaynakça

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