title: Glasgow prognostic score is related to blood transfusion requirements and post-operative complications in hepatic resection for hepatocellular carcinoma.
abstract: BACKGROUND
  Systemic inflammation before surgery, as evidenced by the Glasgow prognostic score (GPS), predicts postoperative complications and cancer-specific survival in various types of cancer. The aim of this study was to evaluate the significance GPS in hepatic resection for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Sixty-six patients who underwent elective hepatic resections for HCC were include in the study. Patients were classified into three groups: GPS 0 [C-reactive protein (CRP)≤1.0 mg/dl and serum albumin ≥3.5 g/dl, n = 54], GPS 1 [CRP >1.0 mg/dl or serum albumin <3.5 g/dl, n = 11], and GPS 2 [CRP>1.0 mg/dl and serum albumin <3.5 g/dl, n = 1]. We retrospectively examined the association between GPS (0 or 1) and perioperative clinical variables and outcome.
  
  
  RESULTS
  In univariate analysis, GPS 0 patients had significantly better preoperative the retention rate of indocyanine green at 15 minutes (ICGR15) (p=0.0418), Child-Pugh classification (p = 0.0075) and model for end-stage liver disease score (p = 0.0007) than did GPS 1 patients. In multivariate analysis, blood loss and GPS 1 were independent risk factors for pulmonary complications (p = 0.0118 for blood loss, p = 0.0143 for GPS 1), red blood cell concentration transfusion (p = 0.0036 for blood loss, p = 0.0117 for GPS 1) and flesh frozen plasma transfusion (p = 0.0020 for blood loss, p = 0.0044 for GPS 1). Albumin product transfusion, duration of operation (p = 0.0478), blood loss (p = 0.0420) and GPS 1 (p = 0.0111) were independent risk factors. Disease-free and overall survival of GPS 0 and GPS 1 patients were comparable.
  
  
  CONCLUSIONS
  GPS reflects preoperative patient status, and is associated with blood transfusion and pulmonary complications in elective hepatic resection for HCC.
authors.affiliation: Department of Surgery, Institute of DNA Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.forename: Kenei
authors.initials: K
authors.lastname: Furukawa
authors.forename: Tomonori
authors.initials: T
authors.lastname: Iida
authors.forename: Koichiro
authors.initials: K
authors.lastname: Haruki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Gocho
authors.forename: Shigeki
authors.initials: S
authors.lastname: Wakiyama
authors.forename: Shoichi
authors.initials: S
authors.lastname: Hirohara
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.forename: Toya
authors.initials: T
authors.lastname: Ohashi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000704:Analysis of Variance; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D002097:C-Reactive Protein / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D015996:Survival Rate
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein