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

Yıl 2022, Cilt: 29 Sayı: 4, 661 - 670, 27.12.2022

Kübra Erdoğan Nisbet Yılmaz Ahmet Erdoğan Osman Sütçüoğlu Ozan Yazıcı Nuriye Yıldırım Özdemir

https://doi.org/10.17343/sdutfd.1193868

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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