Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer.
OBJECTIVE
The aim of the study was to examine the value of the combination of an elevated C-reactive protein and hypoalbuminaemia (GPS) in predicting cancer-specific survival after resection for colon and rectal cancer.


METHODS
The GPS was constructed as follows: Patients with both an elevated C-reactive protein (>10 mg/l) and hypoalbuminaemia (<35 g/l) were allocated a score of 2. Patients in whom only one or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively.


RESULTS
A GPS of 1 (n = 109) was mainly due to an elevated C-reactive protein concentration and the remainder due to hypoalbuminaemia. In those patients with a GPS of 1 due to hypoalbuminaemia (n = 16), the 3-year overall survival rate was 94% compared with 62% in those patients with a GPS of 1 due to an elevated C-reactive protein concentration (n = 93, p = 0.0094). Therefore, the GPS was modified such that patients with hypoalbuminaemia were assigned a score of 0 in the absence of an elevated C-reactive protein. On univariate analysis of those patients with colon and rectal cancer, the modified GPS (p < 0.0001) was significantly associated with overall and cancer specific survival. On univariate survival analysis of those patients with Dukes B colon and rectal cancer, the modified GPS (p < 0.01) was significantly associated with overall and cancer specific survival.


CONCLUSIONS
The results of the present study indicate that the GPS, before surgery, predicts overall and cancer-specific survival after resection of colon and rectal cancer.
McMillan
Donald C
DC
University Department of Surgery, Royal Infirmary, Glasgow, UK. d.c.mcmillan@clinmed.gla.ac.uk
Crozier
Joseph E M
JE
Canna
Khalid
K
Angerson
Wilson J
WJ
McArdle
Colin S
CS
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003110:Colonic Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery; D013505:Digestive System Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood*; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012004:Rectal Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis*; D016896:Treatment Outcome
D015415:Biomarkers; D012709:Serum Albumin; D002097:C-Reactive Protein