Abstract
BackgroundThe systemic inflammation-based Glasgow Prognostic Score (GPS) and modified GPS (mGPS), as measured by preoperative C-reactive protein (CRP) and albumin, correlate with poor survival in several cancers. This study evaluates the prognostic value of these scores in patients with colorectal liver metastases (CRLM). MethodsThis retrospective study assessed the prognostic role of preoperatively measured GPS and mGPS in patients undergoing liver resection because of CRLM. Clinicopathological data were retrieved from local databases. The prognostic value of GPS and mGPS were compared and a Cox regression model was used to find independent predictors of overall survival. ResultsIn total, 849 consecutive patients between January 2005 and December 2015 were included. Patients with GPS 0 had a median survival of 70 months compared to 49 months in patients with GPS 1, and 27 months in patients with GPS 2. Multivariable analyses showed that GPS 1 (HR = 1.51, 95%CI [1.14–2.01]) and GPS 2 (HR = 2.78, 95%CI [1.79–4.31]), after correction for age >70 years (HR = 1.75 [1.36–2.26]), and extended resection (HR = 2.53, 95%CI[1.79–3.58]), were associated with poor overall survival. ConclusionA preoperative GPS is an independent prognostic factor in patients with CRLM, and appears to be a better prognostic tool than mGPS.
Highlights
Colorectal cancer (CRC) is the third most common cancer in the Western world, and the second leading cause of cancer-related death.1 The liver is the most common site of metastasis in CRC
There were no significant differences between the patients that were excluded from the study with the patients that were included, with regards to prognostic variables such as age at surgery, type of resection, tumour burden score (TBS), and Glasgow Prognostic Score (GPS)
This study indicates that preoperative GPS is a strong prognostic factor for long-term survival in patients with colorectal liver metastases (CRLM) undergoing liver resection with curative intent
Summary
Colorectal cancer (CRC) is the third most common cancer in the Western world, and the second leading cause of cancer-related death. The liver is the most common site of metastasis in CRC. In patients with colorectal liver metastases (CRLM), the hepatic involvement of the tumour is a major contributor to their death.. Five-year survival after liver resection ranges between 25 and 58%.8-10. The systemic inflammation-based Glasgow Prognostic Score (GPS) and modified GPS (mGPS), as measured by preoperative C-reactive protein (CRP) and albumin, correlate with poor survival in several cancers. This study evaluates the prognostic value of these scores in patients with colorectal liver metastases (CRLM). Methods: This retrospective study assessed the prognostic role of preoperatively measured GPS and mGPS in patients undergoing liver resection because of CRLM. The prognostic value of GPS and mGPS were compared and a Cox regression model was used to find independent predictors of overall survival. Conclusion: A preoperative GPS is an independent prognostic factor in patients with CRLM, and appears to be a better prognostic tool than mGPS
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