title: Elevated C-reactive protein and hypoalbuminemia measured before resection of colorectal liver metastases predict postoperative survival.
abstract: BACKGROUND
  Few studies have investigated whether the Glasgow Prognostic Score (GPS), an inflammation-based prognostic score measured before resection of colorectal liver metastasis (CRLM), can predict postoperative survival.
  
  
  METHODS
  Sixty-three consecutive patients who underwent curative resection for CRLM were investigated. GPS was calculated on the basis of admission data as follows: patients with both an elevated C-reactive protein (>10 mg/l) and hypoalbuminemia (<35 g/l) were allocated a GPS score of 2. Patients in whom only one of these biochemical abnormalities was present were allocated a GPS score of 1, and patients with a normal C-reactive protein and albumin were allocated a score of 0.
  
  
  RESULTS
  Significant factors concerning survival were the number of liver metastases (p = 0.0044), carcinoembryonic antigen level (p = 0.0191), GPS (p = 0.0029), grade of liver metastasis (p = 0.0033), and the number of lymph node metastases around the primary cancer (p = 0.0087). Multivariate analysis showed the two independent prognostic variables: liver metastases > or =3 (relative risk 2.83) and GPS1/2 (relative risk 3.07).
  
  
  CONCLUSIONS
  GPS measured before operation and the number of liver metastases may be used as novel predictors of postoperative outcomes in patients who underwent curative resection for CRLM.
authors.affiliation: Department of Surgery, Showa General Hospital, Kodaira, Tokyo, Japan. takakobayashi-tky@umin.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masanori
authors.initials: M
authors.lastname: Teruya
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kishiki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Endo
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Takenaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Miki
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Koji
authors.initials: K
authors.lastname: Morita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D034141:Hypoalbuminemia / Q000175:diagnosis*; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein