title: Improvement of high-sensitivity inflammation-based Glasgow prognostic score by gastrectomy is a favorable prognostic factor in patients with gastric cancer.
abstract: OBJECTIVE
  The aim of the present study was to clarify the efficacy of inflammation-based Glasgow prognostic score after surgery in patients with gastric cancer and to determine clinicopathological factors affecting score improvement.
  
  
  METHODS
  Participants in this retrospective study were 236 patients with gastric cancer who underwent gastrectomy at the Fukuoka University Hospital. The high-sensitivity inflammation-based Glasgow prognostic score (HS-GPS) (cut-off values: 0.3 mg/dl for C-reactive protein; 3.5 g/dl for albumin) were calculated before and 1 month after surgery, and correlated to clinicopathological parameters and prognosis after surgery.
  
  
  RESULTS
  HS-GPS was classified as normal (score 0) in 162 patients and abnormal (score 1 or 2) in 74 patients. Out of the 162 patients with normal HS-GPS before surgery, 62 showed abnormal HS-GPS after surgery, while 26 of the 74 patients with abnormal HS-GPS before surgery improved to normal HS-GPS postoperatively. Abnormal HS-GPS before (p<0.0001) and after (p=0.0002) surgery were unfavorable prognostic factors in univariate analysis. HS-GPS after surgery was an independent prognostic factor (p=0.0324) in multivariate analysis, but HS-GPS before surgery was not. In the sub-group with abnormal HS-GPS before surgery (but not normal HS-GPS before surgery), improved HS-GPS after surgery had a favorable prognostic impact in both uni- (p=0.0039) and multivariate analyses (p=0.0032).
  
  
  CONCLUSIONS
  HS-GPS after surgery may be a valuable prognostic factor in patients with gastric cancer. Supplemental therapy represented by adjuvant chemotherapy might be required for gastric cancer patients showing no improvement in HS-GPS after gastrectomy.
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan takeno@fukuoka-u.ac.jp.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Takeno
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shibata
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Maki
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Hironari
authors.initials: H
authors.lastname: Shiwaku
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Yamana
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Risako
authors.initials: R
authors.lastname: Yamashita
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011184:Postoperative Period; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: C-reactive protein; High-sensitivity Glasgow prognostic score; albumin; gastric cancer; surgery