Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer.
OBJECTIVE
To investigate the significance of preoperative Glasgow prognostic score (GPS) for postoperative prognostication of patients with colorectal cancer.


BACKGROUND
Recent studies have revealed that the GPS, an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the GPS in the field of colorectal surgery.


METHODS
The GPS was calculated on the basis of admission data as follows: patients with an elevated level of both CRP (>10 mg/L) and hypoalbuminemia (Alb <35 g/L) were allocated a score of 2, and patients showing 1 or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. Prognostic significance was analyzed by univariate and multivariate analyses.


RESULTS
A total of 315 patients were evaluated. Kaplan-Meier analysis and log-rank test revealed that a higher GPS predicted a higher risk of postoperative mortality (P < 0.01). Univariate analyses revealed that postoperative TNM was the most sensitive predictor of postoperative mortality (odds ratio, 0.148; 95% confidence interval, 0.072-0.304; P < 0.0001). Multivariate analyses using factors such as age, sex, tumor site, serum carcinoembryonic antigen, CA19-9, CA72-4, CRP, albumin, and GPS revealed that GPS (odds ratio, 0.165; 95% confidence interval, 0.037-0.732; P = 0.0177) was associated with postoperative mortality.


CONCLUSIONS
Preoperative GPS is considered to be a useful predictor of postoperative mortality in patients with colorectal cancer.
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan. mm-ishizuka@umin.ac.jp
Mitsuru
M
Ishizuka
Hitoshi
H
Nagata
Kazutoshi
K
Takagi
Toru
T
Horie
Keiichi
K
Kubota
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D002097:C-Reactive Protein