Ann Surg Treat Res.  2014 Jun;86(6):309-313. 10.4174/astr.2014.86.6.309.

Inflammation-based score (Glasgow prognostic score) as an independent prognostic factor in colorectal cancer patients

• Choi KW
• Hong SW
• Chang YG
• Lee WY
• Lee B
• Paik IW
• Lee H

• KMID: 2167108
• DOI: http://doi.org/10.4174/astr.2014.86.6.309

Abstract

PURPOSE
This study was conducted to evaluate the systemic inflammatory response in colorectal cancer patients, and to estimate the usefulness of the Glasgow prognostic score (GPS) as a prognostic factor.
METHODS
Patients with biopsy-proven colorectal adenocarcinoma who were operated between April 2005 and December 2008 were enrolled in this study. The GPS was estimated based on the measurement of CRP and serum albumin level. The GPS was compared with other clinicopathological factors. Univariate and multivariate analyses were performed to evaluate the factors affecting cancer-specific survival.
RESULTS
GPS was significantly higher in patients with anemia, thrombocytosis, a high neutrophil to lymphocyte ratio, tumor of the colon, and large tumor. Patient age, gender, serum CEA level, tumor gross appearance, TNM stage, and tumor differentiation were not related with the GPS. In univariate analysis, hemoglobin, CEA, gross appearance of tumor, TNM stage, tumor differentiation, and GPS were associated with cancer-specific survival. In multivariate analysis, TNM stage (III or IV : I or II; hazard ratio [HR], 12.322; P = 0.015), tumor differentiation (poorly differentiated : well or moderately differentiated; HR, 3.112; P = 0.021), and GPS (GPS 2 : GPS 0 or 1; HR, 5.168; P = 0.003) were identified as independent prognostic factors in colorectal cancer.
CONCLUSION
Our study showed that the GPS was an independent variable from tumor stage and a good and convenient prognostic factor in colorectal cancer patients.

Keyword

Colorectal neoplasms; Inflammation; Prognosis

MeSH Terms

Adenocarcinoma
Anemia
Colon
Colorectal Neoplasms*
Humans
Inflammation
Lymphocytes
Multivariate Analysis
Neutrophils
Prognosis
Serum Albumin
Thrombocytosis
Serum Albumin

Figure

• 

  Fig. 1 Cancer-specific survival curve according to the Glasgow prognostic score (GPS). There was a significant difference in the survival rate according to the GPS (P < 0.001). Survival curve of the patients with a GPS of 0 was not different from that of the patients with a GPS of 1 (P = 0.6027).

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