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Importance of Metastatic Lymph Node Ratio in Non-Metastatic, Lymph Node-Invaded Colon Cancer: A Clinical Trial

Arda Isik, Kemal Peker, Deniz Firat, Bahri Yilmaz, Ilyas Sayar, Oguz Idiz, Coskun Cakir, Ismail Demiryilmaz, Ismayil Yilmaz

Department of General Surgery, Erzincan University, Erzincan, Turkey

Med Sci Monit 2014; 20:1369-1375

DOI: 10.12659/MSM.890804

Available online:

Published: 2014-08-04

Background: The aim of this study was to evaluate the prognostic importance of the metastatic lymph node ratio for stage III colon cancer patients and to find a cut-off value at which the overall survival and disease-free survival change.
Material and Methods: Patients with pathological stage III colon cancer were retrospectively evaluated for: age; preoperative values of Crp, Cea, Ca 19-9, and Afp; pathologic situation of vascular, perineural, lymphatic, and serosal involvement; and metastatic lymph node ratio values were calculated.
Results: The study included 58 stage III colon cancer patients: 20 (34.5%) females and 38 (65.5%) males were involved in the study. Multivariate analysis was applied to the following variables to evaluate significance for overall survival and disease-free survival: age, Crp, Cea, perineural invasion, and metastatic lymph node ratio. The metastatic lymph node ratio (<0.25 or ≥0.25) is the only independent variable significant for overall and disease-free survival.
Conclusions: Metastatic lymph node ratio is an ideal prognostic marker for stage III colon cancer patients, and 0.25 is the cut-off value for prognosis.

Keywords: Colonic Neoplasms - physiopathology, Age Factors, Disease-Free Survival, Lymphatic Metastasis - pathology, Multivariate Analysis, Neoplasm Invasiveness - pathology, Prognosis, Tumor Markers, Biological