Dataset Information

Prognostic value of lymph node ratio in cervical cancer: A meta-analysis.

ABSTRACT:

Background

The role of the lymph node ratio (LNR) in the existing tumor node metastasis classification system should be verified as one of the prognosis prediction factors. This work evaluated LNR's performance in predicting cervical cancer (CC) prognosis through a meta-analysis.

Method

Related studies were retrieved from the Cochrane Library, EMBASE, and PubMed databases. The language was restricted to English. The combined hazard ratios (HRs) were utilized to analyze the prognostic value of LNR.

Results

Our study included 8 articles with 3325 subjects published after 2015. Based on our analysis, high LNR was the adverse prognostic factor for overall survival (OS, HR = 1.45; 95% CI = 1.23-1.73; P = .238) and disease-free survival (DFS, HR = 2.69; 95% CI = 1.98-3.66; P = .597) among the CC cases. Furthermore, as revealed by subgroup analysis, in CC patients, median LNR of about 0.0625 and 0.066 served as the prominent risk factor for DFS and OS.

Conclusions

The current work illustrates that elevated LNR is related to the dismal prognosis of CC. More well-designed clinical studies are warranted for assessing whether LNR is a factor independently predicting the prognosis of CC.

SUBMITTER: Cui H

PROVIDER: S-EPMC9592518 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Prognostic value of lymph node ratio in cervical cancer: A meta-analysis.

Cui Haixia H Huang Yuan Y Wen Weibo W Li Xiangdan X Xu Dongyuan D Liu Lan L

Medicine 20221001 42

<h4>Background</h4>The role of the lymph node ratio (LNR) in the existing tumor node metastasis classification system should be verified as one of the prognosis prediction factors. This work evaluated LNR's performance in predicting cervical cancer (CC) prognosis through a meta-analysis.<h4>Method</h4>Related studies were retrieved from the Cochrane Library, EMBASE, and PubMed databases. The language was restricted to English. The combined hazard ratios (HRs) were utilized to analyze the prognos ...[more]

PMID: 36281189

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Project description:BackgroundTesticular cancer represents the most common malignancy in young adult men. In the current study, we sought to analyze and compare the prognostic value of lymph node ratio (LNR) as well as positive lymph node counts (LNC) to understand its clinical significance in testicular germ cell tumors.MethodsWe employed eligibility criteria to recruit a total of 931 patients, with testicular cancer, from 2010 to 2015 from The Surveillance, Epidemiology, and End Results (SEER) database. We then used the X-Tile program to calculate LNR and LNC cutoff values and discriminate survival. We then calculated the overall and cancer specific survival rates and analyzed the association between LNR/LNC and clinical pathological characteristics using the χ2 test. Finally, we assessed the relationships between clinical pathological factors and patient survival using univariate Cox proportional hazard analysis.ResultsUnivariate analysis revealed a significant association between prognosis with age (HR, 5.169; 95% CI, 1.758-15.200; P = 0.003), AJCC stage (III vs I: HR, 9.298; 95% CI, 2.691-32.131; P < 0.001), M stage (HR, 7.897; 95% CI, 3.417-18.251; P < 0.001) and LNR (HR, 3.009; 95% CI, 1.275-7.098; P = 0.012). On the other hand, LNC (HR, 1.743; 95% CI, 0.687-4.420; P = 0.242) was not significantly associated with prognosis. Analysis of the association between LNR/LNC and clinical pathological characteristics showed that high LNR patients tended to have significantly larger tumor sizes (χ2 = 7.877, P = 0.005), as well as advanced T (χ2 = 13.195, P = 0.004), N ( χ2 = 86.775, P < 0.001), M (χ2 = 19.948, P < 0.001) and 7th AJCC (χ2 = 103.074, P < 0.001) stages. In addition, high LNC patients were significantly associated with T (χ2 = 8.799, P = 0.032), N (χ2 = 74.390, P < 0.001) and 7th AJCC (χ2 = 111.759, P < 0.001) stages.ConclusionLNR was a better predictor for long-term prognosis and was closely associated with clinical pathological characteristics than LNC in patients with testicular germ cell tumors.

Project description:Increasing lymph node ratio (LNR) (ratio of metastatic lymph nodes to the total number of harvested lymph nodes) and extramural vascular invasion (EMVI) have been proposed as adverse prognostic indicators in colorectal cancer, although their use remains variable and controversial. The aim of the present study was to assess the prognostic value of LNR and EMVI in predicting survival for patients undergoing curative colon cancer resection.Between 2006 and 2012, 922 patients underwent curative colon cancer resection. Surgical technique and pathological assessment did not change during the study period. Clinical and pathological data were collected from a prospectively maintained database. The primary outcome measure was overall survival and disease-free survival. LNR was separated into five categories based on three previously calculated cutoff values: LNR 0 (no lymph nodes involved), LNR 1 (ratio 0.01<0.17), LNR 2 (ratio 0.18-0.41), LNR 3 (ratio 0.42-0.69), and LNR 4 (ratio >0.70).Nine hundred and twenty-two patients underwent colon cancer resection. The median follow-up for survivors was 52.8 months (IQR 34.6-77.6). The median total number of lymph nodes harvested was 16 (IQR13-22). On multivariate analysis, both pN and LNR were strongly associated with overall and disease-free survival. Using the Akaike information criterion (AIC), LNR had greater prognostic value compared with pN. For overall survival, compared with patients in LNR category 0, hazard ratios (95% CI) for those in categories 1, 2, 3 and 4 were 1.37 (1.03,1.82), 2.37 (1.70,3.30), 2.40 (1.57,3.65) and 5.51 (3.16,9.58), respectively. For disease-free survival, patients had hazard ratios (95% CI) of 1.78 (1.25,2.52), 3.79 (2.56,5.61), 2.60 (1.50,4.48) and 4.76 (2.21,10.27), respectively. The presence of EMVI was a significant predictor of decreased overall and disease-free survival (P<0.001).This study demonstrated, in the presence of high surgical, oncology and pathological standards, EMVI and increasing LNR were independent predictors of decreased overall and disease-free survival for patients undergoing curative colon cancer resection. LNR was superior to pN stage in predicting overall and disease-free survival.

Dataset Information

Prognostic value of lymph node ratio in cervical cancer: A meta-analysis.

Background

Method

Results

Conclusions

Publications

Prognostic value of lymph node ratio in cervical cancer: A meta-analysis.

Similar Datasets

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