Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer

The authors seek to assess whether the lymph node ratio (LNR) could predict the risk of metachronous liver metastases. Using the goal of sampling 12 lymph nodes for a proper staging of colorectal cancer is often uncommon,and the LNR is what allows for a better prognosis selection of patients. A homogeneous group of 280 patients, followed up for at least 5 years, was evaluated. To highlight the groups with the highest risk of metachronous liver metastases, patients were divided into 4 quartiles groups in relation to the LNR. The number of lymph nodes sampled in group Stage Iwas significantly lower. Even if statistical significance between the global LNR and the development of liver metastases has not been reached, the subdivision into quartiles has made it possible to highlight that in the more advanced ratio groups, a higher incidence of metachronous liver metastases (P < 0.028) was registered and was a different distribution of patients with or without liver metastasis in function of quartiles (P = 0.01). The LNR has enabled us to prognosticate patients who are at greater risk of developing metachronous liver metastases. The lower lymph node sampling in the patients with less advanced staging (I) and in patients with node-negative cancer (I + II) who developed liver metastases, leads us to believe that some patients have been understaged. We believe that the LNR, especially in cases of adequate lymph node sampling, is a useful gauge to better substratify node-positive patients.

Automated summary

The study assesses the feasibility of using lymph node ratio (LNR) to predict the risk of metachronous liver metastases. Patients with higher LNR quartiles were found to have a higher incidence of liver metastases, indicating a potential for better prognosis selection. The study suggests that LNR, especially with adequate lymph node sampling, can be a useful tool for further stratifying node-positive patients.