Glasgow prognostic score predicts postoperative outcome in patients of colon cancer

Abstract

Objective To investigate the significance of preoperative Glasgow prognostic score (GPS) for postoperative prognosis in patients of resectable colon cancer. Recent studies have revealed that the GPS, an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the GPS in the field of colon surgery. Methods The GPS was calculated on the basis of admission data as follows; patients with an elevated level of both CRP ( ＞ 10 mg/L) and hypoalbuminemia (Alb ＜ 35 g/L) were allocated a score of 2, and patients showing 1 or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. Prognostic significance was analyzed by multivariate analyses. Overall survival and disease-free survival was estimated using the Kaplan-Meier method. Results A total of 282 patients were evaluated. Kaplan-Meier analysis and log-rank test revealed that a higher GPS predicted a higher risk of postoperative mortality and reccurence ( P ＜ 0.001 ). multivariate analyses revealed that postoperative TNM was the most sensitive predictor of postoperative mortality (OR, 0.210; 95% CI, 0.102-0.432; P＜0.01) and CEA(OR,0. 356;95% CI,0. 179 -0. 707; P = 0.003),CA19-9(OR,0. 260;95% CI,0. 120 -0. 564;P ＜ 0.01),CRP( OK,4. 503;95% CI, 1. 590 -12. 751 ;P =0.005) , GPS( OR, 0. 340 ;95% CI,0.181 -0.920;P＜0.01)were associated with postoperative mortality. Conclusions Preoperative GPS is considered to be a useful predictor of postoperative mortality in patients with colon cancer. Key words: Colon neoplasms; Outcome scale, glasgow ; C-reactive protein; Hypoproteinemia