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Open AccessArticle

Metastatic Lymph Node Ratio (mLNR) is a Useful Parameter in the Prognosis of Colorectal Cancer; A Meta-Analysis for the Prognostic Role of mLNR

1
Department of Pathology, Eulji University Hospital, Eulji University School of Medicine, Daejeon 35233, Korea
2
Study Group for Meta-Analysis, Eulji University Hospital, Eulji University School of Medicine, Daejeon 35233, Korea
3
Medical Examiner’s office, National Forensic Service, Wonju 26460, Korea
*
Author to whom correspondence should be addressed.
Jung-Soo Pyo and Joo Heon Kim have contributed equally to this study.
Medicina 2019, 55(10), 673; https://doi.org/10.3390/medicina55100673
Received: 19 September 2019 / Accepted: 1 October 2019 / Published: 4 October 2019
Background and objectives: The presenting study aimed to elucidate the prognostic role of the metastatic lymph node ratio (mLNR) in patients with colorectal cancer (CRC), using a meta-analysis. Materials and Methods: Using data from 90,274 patients from 14 eligible studies, we performed a meta-analysis for the correlation between mLNR and survival rate. Besides, subgroup analyses were performed, based on tumor stage, tumor location, and mLNR. Results: A high mLNR showed significant correlation with worse overall survival and disease-free survival rates in CRC patients (hazard ratio (HR), 1.617, 95% confidence interval (CI) 1.393–1.877, and HR 2.345, 95% CI 1.879–2.926, respectively). In patients with stage III, who had regional LN metastasis, the HRs were 1.730 (95% CI 1.266–2.362) and 2.451 (95% CI 1.719–3.494) for overall and disease-free survival, respectively. According to tumor location, rectal cancer showed a worse survival rate when compared to colon cancer. In the analysis for overall survival, when mLNR was 0.2, HR was the highest across the different subgroups (HR 5.040, 95% CI 1.780–14.270). However, in the analysis for disease-free survival, the subgroup with an mLNR < 0.2 had a higher HR than the other subgroups (HR 2.878, 95% CI 1.401–5.912). Conclusions: The mLNR may be a useful prognostic factor for patients with CRC, regardless of the tumor stage or tumor location. Further studies are necessary for the detailed criteria of mLNR before its application in daily practice. View Full-Text
Keywords: metastatic lymph node ratio; colorectal cancer; meta-analysis; prognostic factor metastatic lymph node ratio; colorectal cancer; meta-analysis; prognostic factor
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Pyo, J.S.; Kim, J.H.; Lee, S.Y.; Baek, T.H.; Kang, D.W. Metastatic Lymph Node Ratio (mLNR) is a Useful Parameter in the Prognosis of Colorectal Cancer; A Meta-Analysis for the Prognostic Role of mLNR. Medicina 2019, 55, 673.

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