Radiological lymph‐node size improves the prognostic value of systemic inflammation index in rectal cancer with pathologically negative nodes

Background The relationship between the radiological lymph node (rLN) size and survival outcome in node‐negative rectal cancer is still uncertain. In this study, we aimed to explore the role of enlarged rLN in predicting the survival of node‐negative rectal cancers. Methods We retrospectively review...

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Published in:Cancer medicine (Malden, MA) MA), 2023-05, Vol.12 (9), p.10303-10314
Main Authors: Peng, Shaoyong, Liu, Xiaoxia, Li, Yingjie, Yu, Huichuan, Xie, Yumo, Wang, Xiaolin, Zhou, Jiaming, Zhu, Mingxuan, Luo, Yanxin, Huang, Meijin
Format: Article
Language:English
Subjects:
Archives & records
Cancer
Colonoscopy
Colorectal cancer
Humans
Inflammation
Inflammation - pathology
Leukocytes (neutrophilic)
Lymph nodes
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymph Nodes - surgery
Lymphatic system
Lymphocytes
Metastasis
Multivariate analysis
Neoplasm Recurrence, Local - pathology
Neoplasm Staging
Neutrophils
NLR
node‐negative rectal cancer
Patients
Prognosis
radiological lymph node
Rectal Neoplasms - pathology
Rectum
Retrospective Studies
Risk factors
Surgery
survival outcome
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container_title Cancer medicine (Malden, MA)
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creator Peng, Shaoyong
Liu, Xiaoxia
Li, Yingjie
Yu, Huichuan
Xie, Yumo
Wang, Xiaolin
Zhou, Jiaming
Zhu, Mingxuan
Luo, Yanxin
Huang, Meijin
description Background The relationship between the radiological lymph node (rLN) size and survival outcome in node‐negative rectal cancer is still uncertain. In this study, we aimed to explore the role of enlarged rLN in predicting the survival of node‐negative rectal cancers. Methods We retrospectively reviewed the records of 722 node‐negative rectal cancer who underwent curative resection. Factors associated with DFS (disease‐free survival) and CSS (cancer‐specific survival) were assessed with univariate and multivariate analysis. Survival analysis was performed according to presence with or without enlarged rLN. Combining rLN with NLR as a new index‐inflammation immune score (IIS) for predicting survival. Comparing different models to assess the predictive powers. Results A total of 119 patients had tumor recurrence and 73 patients died due to cancer. Patients with enlarged rLN (≥5 mm) was significantly associated with better DFS (HR:0.517, 95%CI:0.339–0.787, p = 0.002) and CSS (HR:0.43, 95%CI:0.242–0.763, p = 0.004). The risk factors of recurrence were rLN, neutrophil‐lymphocyte ratio (NLR), CEA level, and distance from the anal verge. The risk of recurrence increased by 1.88‐ and 2.83‐fold for the high score in IIS compared with the low and intermediate score group (All p 
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In this study, we aimed to explore the role of enlarged rLN in predicting the survival of node‐negative rectal cancers. Methods We retrospectively reviewed the records of 722 node‐negative rectal cancer who underwent curative resection. Factors associated with DFS (disease‐free survival) and CSS (cancer‐specific survival) were assessed with univariate and multivariate analysis. Survival analysis was performed according to presence with or without enlarged rLN. Combining rLN with NLR as a new index‐inflammation immune score (IIS) for predicting survival. Comparing different models to assess the predictive powers. Results A total of 119 patients had tumor recurrence and 73 patients died due to cancer. Patients with enlarged rLN (≥5 mm) was significantly associated with better DFS (HR:0.517, 95%CI:0.339–0.787, p = 0.002) and CSS (HR:0.43, 95%CI:0.242–0.763, p = 0.004). The risk factors of recurrence were rLN, neutrophil‐lymphocyte ratio (NLR), CEA level, and distance from the anal verge. The risk of recurrence increased by 1.88‐ and 2.83‐fold for the high score in IIS compared with the low and intermediate score group (All p &lt; 0.001). Similarly, the high score in IIS also increased the risk of cancer‐specific death. In the model comparison, the AIC and LR were improved by including the rLN into the NLR model for DFS and CSS prediction (All p &lt; 0.05). Conclusions Node‐negative rectal cancer patients with enlarged rLN had a better survival outcome. IIS might be a more comprehensive and complete inflammation immune index for survival prediction.</description><identifier>ISSN: 2045-7634</identifier><identifier>EISSN: 2045-7634</identifier><identifier>DOI: 10.1002/cam4.5761</identifier><identifier>PMID: 36938675</identifier><language>eng</language><publisher>United States: John Wiley &amp; Sons, Inc</publisher><subject>Archives &amp; records ; Cancer ; Colonoscopy ; Colorectal cancer ; Humans ; Inflammation ; Inflammation - pathology ; Leukocytes (neutrophilic) ; Lymph nodes ; Lymph Nodes - diagnostic imaging ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Lymphatic system ; Lymphocytes ; Metastasis ; Multivariate analysis ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Neutrophils ; NLR ; node‐negative rectal cancer ; Patients ; Prognosis ; radiological lymph node ; Rectal Neoplasms - pathology ; Rectum ; Retrospective Studies ; Risk factors ; Surgery ; survival outcome</subject><ispartof>Cancer medicine (Malden, MA), 2023-05, Vol.12 (9), p.10303-10314</ispartof><rights>2023 The Authors. published by John Wiley &amp; Sons Ltd.</rights><rights>2023 The Authors. Cancer Medicine published by John Wiley &amp; Sons Ltd.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4701-92e3c035bfd7e94c5882638e1f791006291fa944ec290012cfffe626110c64a63</cites><orcidid>0000-0001-8357-1615 ; 0000-0002-5489-4869 ; 0000-0002-8716-2840</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2819859322/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2819859322?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,25753,27924,27925,37012,37013,44590,46052,46476,53791,53793,74998</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36938675$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peng, Shaoyong</creatorcontrib><creatorcontrib>Liu, Xiaoxia</creatorcontrib><creatorcontrib>Li, Yingjie</creatorcontrib><creatorcontrib>Yu, Huichuan</creatorcontrib><creatorcontrib>Xie, Yumo</creatorcontrib><creatorcontrib>Wang, Xiaolin</creatorcontrib><creatorcontrib>Zhou, Jiaming</creatorcontrib><creatorcontrib>Zhu, Mingxuan</creatorcontrib><creatorcontrib>Luo, Yanxin</creatorcontrib><creatorcontrib>Huang, Meijin</creatorcontrib><title>Radiological lymph‐node size improves the prognostic value of systemic inflammation index in rectal cancer with pathologically negative nodes</title><title>Cancer medicine (Malden, MA)</title><addtitle>Cancer Med</addtitle><description>Background The relationship between the radiological lymph node (rLN) size and survival outcome in node‐negative rectal cancer is still uncertain. In this study, we aimed to explore the role of enlarged rLN in predicting the survival of node‐negative rectal cancers. Methods We retrospectively reviewed the records of 722 node‐negative rectal cancer who underwent curative resection. Factors associated with DFS (disease‐free survival) and CSS (cancer‐specific survival) were assessed with univariate and multivariate analysis. Survival analysis was performed according to presence with or without enlarged rLN. Combining rLN with NLR as a new index‐inflammation immune score (IIS) for predicting survival. Comparing different models to assess the predictive powers. Results A total of 119 patients had tumor recurrence and 73 patients died due to cancer. Patients with enlarged rLN (≥5 mm) was significantly associated with better DFS (HR:0.517, 95%CI:0.339–0.787, p = 0.002) and CSS (HR:0.43, 95%CI:0.242–0.763, p = 0.004). The risk factors of recurrence were rLN, neutrophil‐lymphocyte ratio (NLR), CEA level, and distance from the anal verge. The risk of recurrence increased by 1.88‐ and 2.83‐fold for the high score in IIS compared with the low and intermediate score group (All p &lt; 0.001). Similarly, the high score in IIS also increased the risk of cancer‐specific death. In the model comparison, the AIC and LR were improved by including the rLN into the NLR model for DFS and CSS prediction (All p &lt; 0.05). Conclusions Node‐negative rectal cancer patients with enlarged rLN had a better survival outcome. 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In this study, we aimed to explore the role of enlarged rLN in predicting the survival of node‐negative rectal cancers. Methods We retrospectively reviewed the records of 722 node‐negative rectal cancer who underwent curative resection. Factors associated with DFS (disease‐free survival) and CSS (cancer‐specific survival) were assessed with univariate and multivariate analysis. Survival analysis was performed according to presence with or without enlarged rLN. Combining rLN with NLR as a new index‐inflammation immune score (IIS) for predicting survival. Comparing different models to assess the predictive powers. Results A total of 119 patients had tumor recurrence and 73 patients died due to cancer. Patients with enlarged rLN (≥5 mm) was significantly associated with better DFS (HR:0.517, 95%CI:0.339–0.787, p = 0.002) and CSS (HR:0.43, 95%CI:0.242–0.763, p = 0.004). The risk factors of recurrence were rLN, neutrophil‐lymphocyte ratio (NLR), CEA level, and distance from the anal verge. The risk of recurrence increased by 1.88‐ and 2.83‐fold for the high score in IIS compared with the low and intermediate score group (All p &lt; 0.001). Similarly, the high score in IIS also increased the risk of cancer‐specific death. In the model comparison, the AIC and LR were improved by including the rLN into the NLR model for DFS and CSS prediction (All p &lt; 0.05). Conclusions Node‐negative rectal cancer patients with enlarged rLN had a better survival outcome. IIS might be a more comprehensive and complete inflammation immune index for survival prediction.</abstract><cop>United States</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>36938675</pmid><doi>10.1002/cam4.5761</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-8357-1615</orcidid><orcidid>https://orcid.org/0000-0002-5489-4869</orcidid><orcidid>https://orcid.org/0000-0002-8716-2840</orcidid><oa>free_for_read</oa></addata></record>
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subjects Archives & records
Cancer
Colonoscopy
Colorectal cancer
Humans
Inflammation
Inflammation - pathology
Leukocytes (neutrophilic)
Lymph nodes
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymph Nodes - surgery
Lymphatic system
Lymphocytes
Metastasis
Multivariate analysis
Neoplasm Recurrence, Local - pathology
Neoplasm Staging
Neutrophils
NLR
node‐negative rectal cancer
Patients
Prognosis
radiological lymph node
Rectal Neoplasms - pathology
Rectum
Retrospective Studies
Risk factors
Surgery
survival outcome
title Radiological lymph‐node size improves the prognostic value of systemic inflammation index in rectal cancer with pathologically negative nodes
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