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Prognostic value of the lymph node ratio in stage III colorectal cancer: a systematic review

Wim Ceelen UGent, Yves Van Nieuwenhove UGent and Piet Pattyn UGent (2010) ANNALS OF SURGICAL ONCOLOGY. 17(11). p.2847-2855
abstract
Background. Although nodal invasion represents one of the most powerful prognostic indicators in colorectal cancer, marked heterogeneity exists within stage III patients. Recently, the lymph node ratio (LNR), defined as the ratio of the number of positive nodes over the total number of examined nodes, was proposed to stratify outcome in stage III patients. Methods. A systematic search was performed for studies examining the prognostic significance of the LNR in colon or rectal cancer. Individual studies were assessed for methodological quality and summary data extracted. Hazard ratios from multivariate analyses were entered in a fixed-effects meta-analysis model. Results. In total, 16 studies were identified including 33,984 patients with stage III colon or rectal cancer. In all identified studies, the LNR was identified as an independent prognostic factor in patients with stage Ill cancer of the colon or rectum. The prognostic separation obtained by the LNR was superior to that of the number of positive nodes (N stage). The pooled hazard ratios for overall and disease-free survival were 2.36 (95% confidence interval, 2.14-2.61) and 3.71 (95% confidence interval, 2.56-5.38), respectively. Conclusions. The LNR allows superior prognostic stratification in stage Ill colorectal cancer and should be validated in prospective studies.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
CARCINOMA, NUMBER, RESECTION, SURVIVAL, BREAST-CANCER, RECTAL-CANCER, POSITIVE COLON-CANCER, SURGERY, TRIAL, CHEMORADIOTHERAPY
journal title
ANNALS OF SURGICAL ONCOLOGY
Ann. Surg. Oncol.
volume
17
issue
11
pages
2847 - 2855
Web of Science type
Review
Web of Science id
000283400900007
JCR category
SURGERY
JCR impact factor
4.182 (2010)
JCR rank
8/186 (2010)
JCR quartile
1 (2010)
ISSN
1068-9265
DOI
10.1245/s10434-010-1158-1
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2048386
handle
http://hdl.handle.net/1854/LU-2048386
date created
2012-02-28 11:26:23
date last changed
2012-03-22 15:50:52
@article{2048386,
  abstract     = {Background. Although nodal invasion represents one of the most powerful prognostic indicators in colorectal cancer, marked heterogeneity exists within stage III patients. Recently, the lymph node ratio (LNR), defined as the ratio of the number of positive nodes over the total number of examined nodes, was proposed to stratify outcome in stage III patients. 
Methods. A systematic search was performed for studies examining the prognostic significance of the LNR in colon or rectal cancer. Individual studies were assessed for methodological quality and summary data extracted. Hazard ratios from multivariate analyses were entered in a fixed-effects meta-analysis model. 
Results. In total, 16 studies were identified including 33,984 patients with stage III colon or rectal cancer. In all identified studies, the LNR was identified as an independent prognostic factor in patients with stage Ill cancer of the colon or rectum. The prognostic separation obtained by the LNR was superior to that of the number of positive nodes (N stage). The pooled hazard ratios for overall and disease-free survival were 2.36 (95\% confidence interval, 2.14-2.61) and 3.71 (95\% confidence interval, 2.56-5.38), respectively. 
Conclusions. The LNR allows superior prognostic stratification in stage Ill colorectal cancer and should be validated in prospective studies.},
  author       = {Ceelen, Wim and Van Nieuwenhove, Yves and Pattyn, Piet},
  issn         = {1068-9265},
  journal      = {ANNALS OF SURGICAL ONCOLOGY},
  keyword      = {CARCINOMA,NUMBER,RESECTION,SURVIVAL,BREAST-CANCER,RECTAL-CANCER,POSITIVE COLON-CANCER,SURGERY,TRIAL,CHEMORADIOTHERAPY},
  language     = {eng},
  number       = {11},
  pages        = {2847--2855},
  title        = {Prognostic value of the lymph node ratio in stage III colorectal cancer: a systematic review},
  url          = {http://dx.doi.org/10.1245/s10434-010-1158-1},
  volume       = {17},
  year         = {2010},
}

Chicago
Ceelen, Wim, Yves Van Nieuwenhove, and Piet Pattyn. 2010. “Prognostic Value of the Lymph Node Ratio in Stage III Colorectal Cancer: a Systematic Review.” Annals of Surgical Oncology 17 (11): 2847–2855.
APA
Ceelen, Wim, Van Nieuwenhove, Y., & Pattyn, P. (2010). Prognostic value of the lymph node ratio in stage III colorectal cancer: a systematic review. ANNALS OF SURGICAL ONCOLOGY, 17(11), 2847–2855.
Vancouver
1.
Ceelen W, Van Nieuwenhove Y, Pattyn P. Prognostic value of the lymph node ratio in stage III colorectal cancer: a systematic review. ANNALS OF SURGICAL ONCOLOGY. 2010;17(11):2847–55.
MLA
Ceelen, Wim, Yves Van Nieuwenhove, and Piet Pattyn. “Prognostic Value of the Lymph Node Ratio in Stage III Colorectal Cancer: a Systematic Review.” ANNALS OF SURGICAL ONCOLOGY 17.11 (2010): 2847–2855. Print.