Lymph Node Ratio: Is It an Independent Prognostic Factor for Stage III Cutaneous Melanoma?

Document Type: Research Articles

Authors

1 Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

3 Department Of Surgery, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University Of Medical Sciences, Tehran, Iran.

4 Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Objective: Lymph node ratio (LNR) is defined as the ratio of the number of metastatic lymph nodes to the dissected
lymph nodes. LNR is a prognostic factor for many tumor types. The present study aimed to evaluate the prognostic
value of LNR in melanoma. Methods: This retrospective cohort study was conducted on 123 patients with stage III
cutaneous melanoma. Multivariate Cox proportional hazards model was used to evaluate the correlations between LNR
and other clinicopathological factors associated with survival. The patients were divided into four groups in terms of
the LNR, including groups A (LNR≤0.18), B (0.18<LNR≤0.37), C (0.37<LNR≤0.625), and D (LNR>0.625). Results:
Initially, LNR was evaluated as a continuous quantity associated with survival. In the univariate analysis, a significant
correlation was observed between LNR, overall survival (OS), and disease free survival (DFS). Meanwhile, the only
association observed in the multivariate analysis was between LNR and OS. Increased LNR from group A to group D
reduced OS from 46 (±44.09) to 22.5 (±16.33) months (P=0.022). According to the multivariate analysis, prognostic
factors in OS were tumor thickness, American joint committee of cancer (AJCC) N stage, interferon administration,
and undergoing chemotherapy. Conclusion: According to the results, LNR could be used as an independent prognostic
factor for estimating the survival of patients with stage III cutaneous melanoma also designing an effective adjuvant
treatment protocol for these patients.

Keywords

Main Subjects