Proposal of New Classification for Stage III Colon Cancer Based on the Lymph Node Ratio: Analysis of 4,172 Patients from Multi-Institutional Database in Japan

Background We retrospectively examined the optimal lymph node ratio (LNR) cutoff value and attempted to construct a new classification using the LNR in stage III colon cancer. Methods The clinical and pathological data of 4,172 patients with histologically proven lymph node metastasis who underwent...

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Bibliographic Details
Published in:Annals of surgical oncology 2015-02, Vol.22 (2), p.528-534
Main Authors: Sugimoto, Kiichi, Sakamoto, Kazuhiro, Tomiki, Yuichi, Goto, Michitoshi, Kotake, Kenjiro, Sugihara, Kenichi
Format: Article
Language:English
Subjects:
Adenocarcinoma - classification
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Colonic Neoplasms - classification
Colonic Neoplasms - pathology
Colonic Neoplasms - surgery
Colorectal Cancer
Female
Humans
Japan
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Oncology
Prognosis
Retrospective Studies
Surgery
Surgical Oncology
Young Adult
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Summary:Background We retrospectively examined the optimal lymph node ratio (LNR) cutoff value and attempted to construct a new classification using the LNR in stage III colon cancer. Methods The clinical and pathological data of 4,172 patients with histologically proven lymph node metastasis who underwent curative surgery for primary colon cancer at multiple institutions between 1995 and 2004 were derived from the multi-institutional database of the Japanese Society for Cancer of the Colon and Rectum (JSCCR). We determined independent prognostic factors and constructed a new classification using these factors. Finally, we compared the discriminatory ability between the new classification and the TNM seventh edition (TNM 7th) classification. Results The optimal LNR cutoff value was 0.18. Multivariate analysis revealed that year of surgery, age, gender, histological type, TNM 7th T category, lymphatic invasion, venous invasion, TNM 7th N category, and LNR were found to be significant independent prognostic factors. We attempted to construct a new classification based on the combination of TNM 7th T category and LNR. As a result, the cancer-specific survivals were well stratified ( P  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-014-4015-9