title: Influence of inflammation-based prognostic score on mortality of patients undergoing chemotherapy for far advanced or recurrent unresectable colorectal cancer.
abstract: 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.
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan. mm-ishizuka@umin.ac.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ishizuka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nagata
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Takagi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
mesh_terms: 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
chemical_list: D018395:CA-19-9 Antigen; D009944:Organoplatinum Compounds; D012709:Serum Albumin; D002097:C-Reactive Protein; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin