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Lymph Node Ratio Bolsters Standard Staging in Colon Cancer Patients: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 7, 2010 -- The lymph node ratio (LNR) may be a useful addition to standard staging for patients with stage III colon cancer, according to a study presented here on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). In fact, the LNR may help identify patients with the highest relapse risk, select those patients who are most likely to benefit from aggressive therapy and surveillance, and refine patient stratification within clinical trials, the investigators said. Stefano Bordoli, MD, Rush University Medical Center, Chicago, Illinois, and colleagues elsewhere examined the relationship of LNR to survival in patients with colon cancer at a community teaching hospital. Recent data has suggested that the metastatic LNR may have additional prognostic significance in this patient population, and clinical value beyond the American Joint Committee on Cancer (AJCC) N1 and N2 nodal staging designations, according to Dr. Bordoli. The analysis included 184 patients with stage III colon cancer undergoing curative resection between 1995 and 2007 who were followed for a median of 4 years. The mean number of metastatic lymph nodes was 4.02 +- 0.29. The mean LNR was 0.29 +- 0.018. Irrespective of the total number of lymph nodes removed, LNR was a significant predictor of disease recurrence and overall survival. Patients stratified into the highest LNR quartile (LNR >0.44) had significantly worse disease-free survival and overall cancer-specific survival than other stage III patients. Results on multivariate analysis showed that only LNR and receipt of adjuvant chemotherapy retained statistical significance as prognostic factors. The LNR was the strongest predictor of survival even if <12 lymph nodes were harvested. Finally, LNR was a more discriminating predictor of outcome than AJCC N1 compared with N2 classification. Overall, the results suggest that LNR may help strengthen standard staging for patients with stage III colon cancer, Dr. Bordoli said. [Presentation title: The Impact of Metastatic Lymph Node Ratio on Survival in Node-Positive Colon Cancer. Abstract P174 E-mail this page to a friend or colleague! To print, use this version