The metastatic lymph node ratio predicts survival in colon cancer

Paul Schumacher, Sean Dineen, Carlton Barnett, Jason Fleming, Thomas Anthony

Research output: Contribution to journalArticlepeer-review

102 Scopus citations


Background: Lymph node metastases are the most important predictor of survival in non-stage IV colon cancer. Recent studies of gastric cancer have shown a prognostic significance of a lymph node ratio (number of positive nodes divided by total number harvested). Our goal was to determine whether a lymph node ratio (LNR) would predict disease-free survival (DFS) and overall survival (OS) in a tertiary care Veterans Affairs medical center. Methods: A retrospective review of a prospectively collected database of colon cancer patients was performed to determine the effect of LNR on DFS and OS. A cohort of 232 patients with non-stage IV colon cancer was eligible for analysis. Survival curves were constructed using the Kaplan-Meier method. Results: For all patients, a LNR of .08 was identified as a breakpoint for predicting OS and DFS. Specific analysis of stage III patients revealed that a LNR of .18 was predictive of DFS. Conclusions: This study showed the prognostic significance of ratio-based staging for colon cancer and may aid in future staging systems.

Original languageEnglish (US)
Pages (from-to)827-832
Number of pages6
JournalAmerican journal of surgery
Issue number6
StatePublished - Dec 2007


  • Colon cancer
  • Lymph node ratio
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Surgery


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