The Role of Two New Ratios as Predictive Factors of Oncologic Outcome in Stage III Colon and Intra-Peritoneal Rectal Cancer

Rizzo Gianluca, Santullo Francesco, Zaccone Giuseppe, Vernes Elisa, Pafundi Donato Paolo, Biondi Alberto, Persiani Roberto, Verbo Alessandro, Mattana Claudio, Manno Alberto, Rubino Serena and Coco Claudio

Department of Digestive System and Metabolic Endocrine System, Abdominal Surgical Area University Hospital Policlinics Foundation "Agostino Gemelli" - Catholic University of the Sacred Heart, Largo A. Gemelli, 8 - 00168 Rome, Italy

^*Correspondance to: Gianluca Rizzo 

 PDF  Full Text DOI: 10.25107/2474-1647.1504

Abstract

Purpose: Aim of the study was to evaluate the role of 2 ratios as predictive factors of Overall Survival (OS) and Disease-Free Survival (DFS).Methods: Stage III colon and intra-peritoneal rectal cancer patients treated from 2000 to 2010 entered the study. A statistical analysis was performed to identify variables predicting OS and DFS. The role of 2 variables was evaluated: Length-Node ratio (maximal length of the tumor divided by the lymph node ratio); Length-Node-Tumor ratio (maximal length of the tumor divided by the product of lymph node ratio and pT stage).Results: One hundred eighteen patients underwent to radical surgery. The median maximal length of the tumor was 4 cm. The most frequent pT stage was pT3 (69.4%). The median number of harvested lymph nodes and lymph node ratio was respectively 15 and 0.154. Median value of Length-Node and Length-Node-Tumor ratio was respectively 27.083 and 8.889. After a median follow-up of 48 months, the cancer recurrence rate was 33.1%. The actuarial 5-y OS and 5-y DFS were respectively 71% and 66.1%. At multivariate analysis the male sex (p: 0.002), the occurrence of post-operative complications (p: 0.002) and a value lower than median of Length-Node ratio (: 0.001) and LengthNode-Tumor ratio (p<0.001) were identified as independent factors predicting worse OS. A value lower than median of Length-Node ratio (p: 0.017) and Length-Node-Tumor ratio (p: 0.006) were identified as the only independent factors predicting worse DFS.Conclusion: Length-Node and Length-Node-Tumor ratio seem to be prognostic factors significantly related with the oncological outcome of stage III colorectal cancer.

Keywords

Colon cancer; Intra-peritoneal rectal cancer; Metastatic lymph node; Harvested lymph nodes; Lymph node ratio; Oncologic outcome

Cite the article

Gianluca R, Francesco S, Giuseppe Z, Elisa V, Paolo PD, Alberto B, et al. The Role of Two New Ratios as Predictive Factors of Oncologic Outcome in Stage III Colon and Intra-Peritoneal Rectal Cancer. Clin Surg. 2017; 2: 1504.