Influence of inflammation-based prognostic score on mortality of patients undergoing chemotherapy for far advanced or recurrent unresectable colorectal cancer.
BACKGROUND
Recent studies have revealed that the modified Glasgow Prognostic Score (mGPS), 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 mGPS in patients undergoing chemotherapy for far-advanced or recurrent unresectable colorectal cancer (AR-UCRC).


OBJECTIVE
To demonstrate the influence of the mGPS for prognostication of patients undergoing chemotherapy for AR-UCRC.


METHODS
The mGPS was calculated as follows: patients with an elevated level of CRP (>1.0 mg/dL) were allocated a mGPS of 1 or 2 depending on the absence or presence of hypoalbuminemia (<3.5 g/dL) and patients showing no elevated level of CRP (< or =1.0 mg/dL) were allocated a mGPS of 0. Prognostic significance was analyzed by Kaplan-Meier, univariate, and multivariate analyses.


RESULTS
One hundred twelve patients who had undergone chemotherapy for AR-UCRC with regimens such as FOLFIRI (5-fluorouracil/l-leucovorin/irinotecan hydrochloride) or FOLFOX (5-fluorouracil/oxialiplatin) were evaluated retrospectively. Kaplan-Meier analysis and log-rank test revealed that mGPS 2 predicted a higher risk of mortality than mGPS 0 or 1 (P < 0.0001). Univariate analyses revealed that the neutrophil ratio (P = 0.0411), CA 19-9 (P = 0.0473), CRP (P = 0.0477), albumin (P = 0.0043), and mGPS (0, 1/2) (P < 0.0001) were associated with mortality. Multivariate analyses using these 5 factors revealed that only mGPS (0, 1/2) (odds ratio: 6.071; 95% CI: 1.625-22.68; P = 0.0073) was an independent risk factor of mortality.


CONCLUSIONS
mGPS is an important and independent predictor of mortality in patients undergoing chemotherapy for AR-UCRC.
Ishizuka
Mitsuru
M
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan. mm-ishizuka@umin.ac.jp
Nagata
Hitoshi
H
Takagi
Kazutoshi
K
Kubota
Keiichi
K
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism*; D018395:CA-19-9 Antigen; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006305:Health Status Indicators; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D016019:Survival Analysis; D016896:Treatment Outcome
D018395:CA-19-9 Antigen; D009944:Organoplatinum Compounds; D012709:Serum Albumin; D002097:C-Reactive Protein; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin