Stage IV CRC: lymph node status and LNR correlate with survival

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Takeaway

  • In patients with stage IV colorectal cancer (CRC), nodal status and ratio of metastatic to examined lymph node (LNR) are important prognostic factors that correlate with survival independent of chemotherapy and metastasectomy.

Study design

  • Retrospective cohort study of patients diagnosed with synchronous metastatic CRC in Saskatchewan, Canada, from 1992 to 2010 who underwent primary tumor resection.

Key results

  • 1109 patients included in the analysis: median patient age was 70 y (22-98 y) and male-to-female ratio was 1.2:1.
  • Rectal cancer was identified in 26% of patients; 96% had T3/T4 tumor and 82% had node-positive disease.
  • Median LNR was 0.36 (0-1.0); 54% received chemotherapy.
  • Median overall survival of patients with LNR <0.36 who received chemotherapy was 29.7 mo (95% CI, 26.6-32.9) vs 15.6 mo (95% CI, 13.6-17.6) for LNR ≥0.36 (P<.001).
  • On multivariate analyses, the following were...