title: Prognostic value of preoperative inflammation-based prognostic scores in patients with stage IV colorectal cancer who undergo palliative resection of asymptomatic primary tumors.
abstract: BACKGROUND
  The need for palliative resection of asymptomatic primary tumor in patients with unresectable metastatic colorectal cancer (CRC) is still controversial. In order to identify predictors of survival after palliative resection, we investigated the correlations between clinicopathological factors, preoperative Glasgow prognostic score (GPS) and neutrophil-to-lymphocyte ratio (NLR), and survival.
  
  
  METHODS
  A total of 94 patients were enrolled in the present study. The prognostic value of the clinicopathological factors, GPS and NLR were analyzed retrospectively.
  
  
  RESULTS
  A multivariate analysis revealed that both the GPS and NLR were independent predictors of survival along with the preoperative Eastern Cooperative Oncology Group performance status (PS) and extent of distant metastasis. We classified the patients using a combination of these factors, and categorized them into three risk groups. The median survival time was five months in the high-risk group, compared to 21.5 months in the intermediate-risk group and 37 months in the low-risk group.
  
  
  CONCLUSIONS
  Sub-classification based on the GPS, NLR, PS and extent of distant metastasis can classify patients into three independent groups. There may be no survival benefits associated with palliative resection in the high-risk group.
authors: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan. m1378386@med.osaka-cu.ac.jp.
authors: Kiyoshi
authors: K
authors: Maeda
authors: Masatsune
authors: M
authors: Shibutani
authors: Hiroshi
authors: H
authors: Otani
authors: Hisashi
authors: H
authors: Nagahara
authors: Kenji
authors: K
authors: Sugano
authors: Tetsuro
authors: T
authors: Ikeya
authors: Ryosuke
authors: R
authors: Amano
authors: Kenjiro
authors: K
authors: Kimura
authors: Katsunobu
authors: K
authors: Sakurai
authors: Naoshi
authors: N
authors: Kubo
authors: Kazuya
authors: K
authors: Muguruma
authors: Hiroaki
authors: H
authors: Tanaka
authors: Toru
authors: T
authors: Inoue
authors: Kosei
authors: K
authors: Hirakawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Colorectal cancer; Glasgow prognostic score; asymptomatic primary tumor; neutrophil to lymphocyte ratio; palliative surgery; stage IV