Abstract 87P
Background
Survival outcome in rectal cancer primarily determined by nodal status and stage of tumour. Though nodal invasion is strong prognostic indicator in rectal cancer, there exists marked heterogenecity within stage III patients. We investigated the prognostic impact of ratio of positive lymph nodes to total number of retrieved nodes (LNR), ratio of positive to negative lymph nodes (PN-LNR) and negative to positive nodes (NP-LNR) on survival in patients with node positive rectal cancers.
Methods
This is a retrospective analysis of 336 patients of rectal cancer who underwent surgery and adjuvant therapy between 2011 to 2014. The node positive patients were grouped into two groups based on quartiles of LNR <0.2 and >0.2, PN-LNR <0.36 and >0.36 and NP-LNR <2.38 and >2.38. The association between LNR, PN-LNR and NP-LNR and survival was evaluated by the Kaplan-Meier method and multivariate analysis with covariates of prognostic significance in univariate analysis.
Results
Patients classified as LNR <0.2 and >0.2 had a 5-year OS of 86.8 and 64.4 (p < 0.001) and DFS of 85.4 and 59.9 respectively (p < 0.001). The 5-year OS rate for PN-LNR <0.36 and >0.36 were 85.1 and 55.1 (p < 0.001) and DFS of 83.9 and 49.3 respectively (p < 0.001). The 5-year OS rate for NP-LNR <2.38 and >2.38 were 53.1 and 87.3 (p < 0.001) and DFS of 47.5 and 85.6 respectively (p < 0.001). OS and DFS of stage III A, III B, III C were 80.3,75.3, and 53.3 (p < 0.001) and 79.5,71.8 and 47.8 respectively (p < 0.001). On univariate analysis, pN status, sex, grade, histology of tumour, LNR, PN-LNR, NP-LNR were found to be significator factors for OS. On multivariate analysis, NP-LNR was found to be significant factor for OS. (p < 0.001, HR = 17.857; [3.557-89.657]). Factors that were found to be significant for DFS were pN status, LNR, PN-LNR, NP-LNR on univariate analysis and NP-LNR on multivariate analysis. (p < 0.001, HR = 11.41; [1.928-67.634]). NP-LNR is found to a significant factor for OS and DFS both on univariate and multivariate analysis.
Conclusions
The NP-LNR was recognised as an independent prognostic factor in node positive rectal cancer patients. Hence, it can be used as an independent prognostic factor and permits superior prognostic stratification in stage III rectal cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Kidwai Memorial Institute of Oncology.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
27P - The prognostic value of neutrophil to lymphocyte ratio (NLR) and 18F-FDG PET SUV in breast cancer patients underwent neoadjuvant chemotherapy
Presenter: Soong June Bae
Session: Poster display session
Resources:
Abstract
28P - Accuracy of core biopsy in predicting pathologic complete response in the breast in patients with complete/near complete clinical and radiological response (Complete Responders in the Breast – CRBr): A feasibility study
Presenter: Nisha Hariharan
Session: Poster display session
Resources:
Abstract
29P - Tumour response to neoadjuvant chemotherapy in breast cancer: Routine pathologic markers improve the predictive power of a cell-loss metric based on release of thymidine kinase 1 into blood
Presenter: Bernhard Tribukait
Session: Poster display session
Resources:
Abstract
30P - Comparison of metabolic changes between neoadjuvant chemotherapy and neoadjuvant endocrine therapy in premenopausal women with ER positive, HER2 negative breast cancer
Presenter: Ho-hyun Ryu
Session: Poster display session
Resources:
Abstract
31P - Circulating miR-155 as a potential therapeutic monitoring marker in breast cancer
Presenter: Sumadi Lukman Anwar
Session: Poster display session
Resources:
Abstract
32P - Profile of breast cancer epidemiology in Sanglah General Hospital, Denpasar, Bali from 2012 to 2019
Presenter: Citra Aryanti
Session: Poster display session
Resources:
Abstract
33P - Contrast enhanced chest CT in patients with breast cancer: Comprehensive imaging analysis and correlation with biological markers
Presenter: Bo Hwa Choi
Session: Poster display session
Resources:
Abstract
34P - Verification of metabolic regulatory mechanisms in androgen receptor-positive triple negative breast cancer
Presenter: Yuka Asano
Session: Poster display session
Resources:
Abstract
35TiP - Ribociclib plus goserelin with hormonal therapy versus physician choice chemotherapy in pre-/perimenopausal patients with HR+, HER2– inoperable locally advanced breast cancer (ABC): RIGHT choice study
Presenter: Yen-Shen Lu
Session: Poster display session
Resources:
Abstract
36TiP - A prospective study to assess response to neoadjuvant hormonal therapy in postmenopausal women with hormone-receptor positive breast cancer at a regional cancer centre in South India
Presenter: Shina Goyal
Session: Poster display session
Resources:
Abstract