Abstract
Systemic inflammation, as evidenced by the Glasgow prognostic score (GPS), predicts cancer-specific survival in various cancer types. The aim of this study was to evaluate the significance of the GPS in the therapeutic outcome of the patient following surgical resection for hepatocellular carcinoma. In total, 144 patients underwent surgical resection for hepatocellular carcinoma. For the assessment of systemic inflammatory response using the GPS, patients were classified into three groups: Patients with normal serum albumin (<3.5 g/dl) and normal serum C-reactive protein (CRP) (≤1.0 mg/dl) were classified as GPS 0 (n=76), those with low serum albumin (<3.5 g/dl) or elevated serum CRP (>1.0 mg/dl) were classified as GPS 1 (n=58), and those with low serum albumin (<3.5 g/dl) and elevated serum CRP (>1.0 mg/dl) were classified as GPS 2 (n=10). Retrospectively, the relationship between patient characteristics including GPS, disease-free as well as overall survival were investigated. In disease-free survival, GPS 2 (P=0.019), with a tumor number ≥3 (P=0.004), and positive portal or venous invasion (P=0.034) were independent predictors of cancer recurrence in multivariate analysis. In overall survival, GPS 1 (P=0.042), GPS 2 (P<0.001) and positive portal or venous invasion (P<0.001) were independent predictors of poor patient outcome according to multivariate analysis. To conclude, the GPS in patients with hepatocellular carcinoma is an independent prognostic predictor after hepatic resection.
Highlights
Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide, the seventh most common cancer, and the third leading cause of cancer‐related deaths [1]. operative mortality and morbidity of hepatic resection in patients with HCC have been minimized by advances in surgical techniques, instruments, and perioperative management, therapeutic outcomes remain unsatisfactory due to the high incidence of recurrence [2,3]
We retrospectively evaluated whether the Glasgow prognostic score (GPS) predicts disease‐free or overall survival after hepatic resection for HCC
GPS consisted of GPS 0 in 76, GPS 1 in 58, and GPS 2 in 10 patients, respectively
Summary
Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide, the seventh most common cancer, and the third leading cause of cancer‐related deaths [1]. operative mortality and morbidity of hepatic resection in patients with HCC have been minimized by advances in surgical techniques, instruments, and perioperative management, therapeutic outcomes remain unsatisfactory due to the high incidence of recurrence [2,3]. The presence of the systemic inflammatory response is associated with poor therapeutic outcome in patients with malignant tumors. Several recent investigators reported that the systemic inflammatory response by the combination of serum C‐reactive protein (CRP) and albumin concentrations, i.e., Glasgow prognostic score (GPS), predicts cancer‐specific survival [9,10,11,12,13,14]. We previously reported the GPS as a predictor of long‐term therapeutic outcome for hepatobiliary malignancies, including carcinoma of the ampulla of Vater [15], gallbladder cancer [16], and unresectable colorectal cancer liver metastasis [17]. There have been only few reports on the relationship between the GPS and long‐term outcome after hepatic resection for HCC [18,19]. We retrospectively evaluated whether the GPS predicts disease‐free or overall survival after hepatic resection for HCC
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