Evaluation of LNR and modified N stage systems for prognostic stratification of metastatic lymph nodes in stage III colorectal Cancer

被引：0
作者：
Zhao-Fu Qin [1 ]
Xin-Yi Gao [2 ]
Yan-Zhi Zhu [3 ]
Ting Ma [1 ]
Guan-Liang Chen [4 ]
De-Ning Ma [1 ]
Hong-Zhou Zhu [5 ]
Long-Hai Feng [2 ]
机构：
[1] Department of Colorectal Surgery, Zhejiang Cancer Hospital, Zhejiang, Hangzhou
[2] Department of Radiology, Zhejiang Cancer Hospital, 1 Banshan East Road, Zhejiang, Hangzhou
[3] School of Pharmacy, University of Sydney, Camperdown, 2050, NSW
[4] Department of General Surgery, Affiliated Hospital of Shaoxing University, Yuecheng District, Zhong Xing Nan Road No. 999, Shaoxing
[5] Postgraduate training base Alliance (Zhejiang Cancer Hospital), Wenzhou Medical University, Zhejiang Province, Hangzhou
来源：
Scientific Reports | / 15卷 / 1期
关键词：
Colorectal cancer; Log odds of positive lymph nodes; Lymph node metastasis; Lymph node ratio; Prognosis;
D O I：
10.1038/s41598-025-96652-w
中图分类号：
学科分类号：
摘要：
Lymph node ratio (LNR) and log odds of positive lymph nodes (LOODS) are considered to be potentially more rigorous metastatic lymph node stratification patterns than AJCC N stage due to the integration of the number of examined lymph nodes. Based on the data of colorectal cancer obtained from the Surveillance, Epidemiology, and End Result (SEER) database, comparison of the stratification performance between different prognostic models was validated by statistical methods, includingchi-square test, Cox regression analysis, Kaplan–Meier survival analysis, and Time-dependent Area Under Curve. A prognostic outcome-oriented statistical method based on Log-rank test was performed to determine the cutoff value of LNR. External validation cohort obtained from Zhejiang Cancer Hospital was used to validate the model performance and cutoff value. In the SEER database cohort, the optimal cutoff value for adequate or inadequate lymph node clearance was 14. In performance comparisons, LNR performance was superior to lymph node count alone and similar to LODDS. The optimal cutoff values for LNR were analyzed to be 0.11 (P < 0.001), 0.39 (P < 0.001) and 0.68 (P < 0.001), respectively. The stratification performance of modified N stage phased with the above cutoff value outperforms AJCC N stage. Kaplan–Meier survival analysis of the differences in patient distribution between the two staging systems also demonstrated the excellence of the LNR system. Above results were verified in the external verification cohort. The modified N stage based on LNR has better stratification performance than the AJCC N stage. © The Author(s) 2025.
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