Prognostic Value of Lymph Node Ratio in Patients with Resected Synchronous Colorectal Liver Metastases and Less Than 12 Examined Lymph Nodes

Alexandrescu, Sorin; Selaru, Florin M.; Diaconescu, A.; Zlate, C.; Blanita, Diana; Grigorie, Răzvan; Zarnescu, Narcis; Herlea, Vlad; Popescu, Irinel

doi:10.1007/s11605-021-05079-x

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…Alexandrescu ST et al. evaluated the role of LNR in predicting prognosis of patients with synchronous liver metastases and found that LNR was the only independent predictor of both DFS and OS ( 44 ).…”

Section: Lymph Node Ratio and Log Odds Of Positive Lymph Nodesmentioning

confidence: 99%

Beyond N staging in colorectal cancer: Current approaches and future perspectives

et al. 2022

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Traditionally, lymph node metastases (LNM) evaluation is essential to the staging of colon cancer patients according to the TNM (tumor–node–metastasis) system. However, in recent years evidence has accumulated regarding the role of emerging pathological features, which could significantly impact the prognosis of colorectal cancer patients. Lymph Node Ratio (LNR) and Log Odds of Positive Lymph Nodes (LODDS) have been shown to predict patients’ prognosis more accurately than traditional nodal staging and it has been suggested that their implementation in existing classification could help stratify further patients with overlapping TNM stage. Tumor deposits (TD) are currently factored within the N1c category of the TNM classification in the absence of lymph node metastases. However, studies have shown that presence of TDs can affect patients’ survival regardless of LNM. Moreover, evidence suggest that presence of TDs should not be evaluated as dichotomic but rather as a quantitative variable. Extranodal extension (ENE) has been shown to correlate with presence of other adverse prognostic features and to impact survival of colorectal cancer patients. In this review we will describe current staging systems and prognostic/predictive factors in colorectal cancer and elaborate on available evidence supporting the implementation of LNR/LODDS, TDs and ENE evaluation in existing classification to improve prognosis estimation and patient selection for adjuvant treatment.

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Section: Lymph Node Ratio and Log Odds Of Positive Lymph Nodesmentioning

confidence: 99%

Beyond N staging in colorectal cancer: Current approaches and future perspectives

et al. 2022

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“…Lymph node (LN) metastasis is a significantly poor prognostic factor for cancer patients. 1 Recently, the possibility of hematogenous distant metastasis has been proposed as “LN‐mediated hematogenous metastasis theory,” in which tumor cells that reach the sentinel LN lymphatically proliferate in the marginal sinus and invade the veins perforating the LN and the surrounding area at the early stage of metastasis. 2 , 3 Therefore, early treatment of nonenlarged false‐negative LNs (i.e., clinical N0 LNs), which are difficult to diagnose metastases with current clinical imaging equipment, will lead to not only better treatment of metastatic LNs but also the prevention of distant metastasis.…”

Section: Introductionmentioning

confidence: 99%

“…Lymph node (LN) metastasis is a significantly poor prognostic factor for cancer patients 1 . Recently, the possibility of hematogenous distant metastasis has been proposed as “LN‐mediated hematogenous metastasis theory,” in which tumor cells that reach the sentinel LN lymphatically proliferate in the marginal sinus and invade the veins perforating the LN and the surrounding area at the early stage of metastasis 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Combination therapy of lymphatic drug delivery and total body irradiation in a metastatic lymph node and lung mouse model

et al. 2022

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Chemotherapy using a lymphatic drug delivery system (LDDS) targeting lymph nodes (LNs) in the early stage of metastasis has a superior antitumor effect to systemic chemotherapy. An LDDS produces a higher drug retention rate and tissue selectivity in LNs. To expand the therapeutic coverage of LDDS from local treatment of metastatic LNs to prevention of distant metastases, the combination of treatment with therapies that enhance systemic tumor immune effects is an important therapeutic strategy. Recently, total body irradiation (TBI) has been shown to activate immune responses and alter the tumor microenvironment. Here we show that combination therapy with TBI and LDDS improves the antitumor effect of metastatic LNs and lung metastasis. Tumor cells were inoculated into the subiliac LN (SiLN) to induce metastasis into the proper axillary LN (PALN) and lung in a mouse model. TBI was carried out on day 4 after inoculation using a gamma irradiator. Lymphatic drug delivery into the accessory axillary LN was used to treat PALN. In vivo bioluminescence imaging, high‐frequency ultrasound, and histology showed that combination therapy using TBI (total dose 1.0 Gy once) and the LDDS suppressed tumor growth in LNs and lung metastases and was more effective than using LDDS or TBI alone. Quantitative RT‐PCR of spleens after combination therapy revealed increased expression of CD4 , CD8 , and IL‐12b , indicating an activated immune response. The results show that combination therapy with TBI and LDDS is a method to improve the efficacy of LN metastases and distant metastases therapy and is a promising novel approach to treat cancer patients.

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Nomograms predicting prognosis for locally advanced hypopharyngeal squamous cell carcinoma

Yang

Zeng

Cao

et al. 2021

Eur Arch Otorhinolaryngol

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Prognostic Value of Lymph Node Ratio in Patients with Resected Synchronous Colorectal Liver Metastases and Less Than 12 Examined Lymph Nodes

Cited by 5 publications

References 21 publications

Beyond N staging in colorectal cancer: Current approaches and future perspectives

Beyond N staging in colorectal cancer: Current approaches and future perspectives

Combination therapy of lymphatic drug delivery and total body irradiation in a metastatic lymph node and lung mouse model

Nomograms predicting prognosis for locally advanced hypopharyngeal squamous cell carcinoma

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