title: New Prognostic Scoring System for Incurable Stage IV Colorectal Cancer.
abstract: BACKGROUND
  Components of the systemic inflammatory response, combined to form inflammation-based prognostic scores (mGPS, NLR, PLR, PI, PNI) have been associated with overall survival. The aim of the present study was to compare various prognostic factors including many previously established parameters and such systemic inflammation-based prognostic scores in a series of incurable stage IV colorectal cancer (CRC) patients.
  
  
  METHODS
  Patients (n=167) with stage IV CRC undergoing surgical procedures between 2005 and 2013 were enrolled. Preoperatively (7-30 days before surgery), routine laboratory examinations were performed on the same day. We calculated scores using these data and analyzed the association with cancer specific survival (CSS) statistically.
  
  
  RESULTS
  Univariate analysis revealed significant associations between CSS and WBC, albumin, CRP, CEA values, mGPS, PNI, and PI values among preoperative factors. On multivariate analysis, high mGPS and high CEA independently predicted shorter CSS (p=0.001 and p=0.018). A new scoring system was constructed using mGPS and CEA. When patients were separated into three categorized using this system, the new score accurately predicted CSS (p < 0.001).
  
  
  CONCLUSIONS
  The present study indicates that a new scoring system, consisting of mGPS and CEA, is a simple and useful tool in predicting the survival of patients with incurable stage IV CRC, and should be included in the routine assessment of these patients for decision making of appropriate treatment.
authors.affiliation: Surgery, Kyorin University School of Medicine, Tokyo, Japan E-mail : kishiki@ks.kyorin-u.ac.jp.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kishiki
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Masaki
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Mastuoka
authors.forename: Nobustugu
authors.initials: N
authors.lastname: Abe
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Mori
authors.forename: Masanori
authors.initials: M
authors.lastname: Sugiyama
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001792:Blood Platelets / Q000473:pathology; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008207:Lymphatic Metastasis; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D018836:Inflammation Mediators