Lymph node ratio and kras mutation in risk stratification of colon cancer

Background:
Colorectal cancer (CRC) considered to be third prevalent and the fourth leading cause of death among all cancers. Nowadays, there are multiple gene assays provide expected information about prognosis of CRC.
Materials and methods:
This study included 433 patients stage III colon cancer. After surgical resection of tumor, patients with inadequate LN resection (12 LN) excluded from the study. Lymph node ratio (LNR) determined by (metastatic lymphatic node number/total excised lymphatic node number). Different clinicopathological parameters, PFS and OS have been tested and compared with LNR.
Results:
287 (66.7%) patients had Lymph node ratio 0.5 (LNR3) group. Baseline Carcino Embryonic Antigen (CEA) level in patients with LNR > 0.5 was statistically high than patients with LNR < 0.2 (P 0.04). High grade tumors (3 & 4) found to be associated with more LNR in comparison to low grade tumors (1& 2) however p value was not significant. LNR was considerably higher in larger tumor size (T3&T4) versus smaller tumors (T1&T2), p < 0.001. Left sided colon cancer documented significantly more LNR3 than right sided colonic tumors; (53.8% versus 46.2%); with p value Conclusion:
In stage III colon cancer, a high lymph node ratio observed a high CEA, left side tumours, T3 & T4 pathologies, high tumour grade, wild K-ras, low PFS, and OS. When the effectiveness of the LNR has been validated in other trials, it can be used for risk stratification and personalization of r along with k ras.