Prognostic Significance of LODDS in Right-sided Colon Cancer: A Retrospective Analysis

Abstract

Objective: The conventional tumor, node, metastasis (TNM) staging system for colorectal cancer possesses inherent limitations due to its dependence on lymph node dissection completeness. This study assessed the prognostic performance of the log odds of positive lymph nodes (LODDS) and lymph node ratio (LNR) against traditional TNM staging in patients who received curative resection for right-sided colon cancer.
Methods: We conducted a retrospective analysis of 132 patients who underwent curative resection for right-sided colon cancer between November 2014 and January 2020. LODDS and LNR were calculated and categorized using published cut-off values. Kaplan-Meier survival analysis and multivariable Cox proportional hazards regression identified independent predictors of 5-year mortality.
Results: During a median follow-up of 90.2 months, the 5-year overall survival rate was 50.2%. Multivariate Cox regression confirmed LODDS category, LNR category, AJCC stage, and patient age as independent predictors of 5-year mortality. Mortality hazard was markedly elevated for the highest-risk LODDS group [LODDS 2 versus LODDS 0: hazard ratio (HR) = 22.322; p < 0.001] compared to the highest LNR category (LNR 2 versus LNR 0: HR = 4.356; p = 0.001).
Conclusion: Both LODDS and LNR function as robust independent prognostic markers for 5-year mortality following curative resection for right-sided colon cancer. However, LODDS demonstrates superior discriminatory power in identifying patients at highest risk. Incorporating LODDS into clinical assessment could enhance risk stratification and inform adjuvant treatment strategies.