What is it about?

Lymph node ratio appears to be more accurate prognostic factor for patients with locally advanced rectal cancer than ypN categories. This paper revealed that LNR 0.41 can prognosticate survival better than ypN categories. Moreover, it was showed that number or harvested lymph nodes is not diminished after preoperative short-course radiotherapy!

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Why is it important?

TNM staging method and LNR with differently calculated cutoff points were evaluated as prognostic tool for rectal cancer. No specific cutoff value was established in previous studies but a few of the studies revealed LNR as independent prognostic factor in locally advanced rectal cancer. In the present study LNR value was assessed in patients included in a randomised controlled trial (Krakow Rectal Cancer Trial) and its value was confirmed. Contrary to some previous studies we showed that neoadjuvant radiotherapy is not associated with low number of harvested lymph nodes.


Currently a multicenter, international validation study is being performed to confirm obtained results. The BARO-1 trial revealed that LNR enables prognostication not only in rectal cancer after 5x5 Gy radiotherapy but also in other rectal cancer patient. As for 4th January 2023 the statistical analyses are finished and the validation study paper is being prepared for publication.

Dr Radoslaw Pach
Jagiellonian University

Read the Original

This page is a summary of: Prognostic value of lymph node ratio in resectable rectal cancer after preoperative short-course radiotherapy—results from randomized clinical trial, Langenbeck s Archives of Surgery, July 2022, Springer Science + Business Media, DOI: 10.1007/s00423-022-02603-8.
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