Prognostic Significance of a Systemic Inflammatory Response in Patients Undergoing Multimodality Therapy for Advanced Colorectal Cancer

Abstract

Objectives: The inflammation-based Glasgow Prognostic Score (GPS) is associated with outcome in a variety of cancers. This study investigated whether a modified GPS (mGPS) could predict survival in patients undergoing multimodality therapy for advanced colorectal cancer (CRC). Methods: We enrolled 245 patients with advanced CRC who received chemotherapy. The mGPS was recorded prior to first-line chemotherapy and to cytoreductive therapy including secondary surgery and/or radiofrequency ablation. The prognostic significance of the mGPS was analyzed using Kaplan-Meier, univariate, and multivariate analyses. Results: In patients who received chemotherapy alone (n = 163), the mGPS prior to chemotherapy was an independent prognostic indicator of survival [odds ratio (OR) 1.858; 95% confidence interval (CI) 1.213–2.846; p = 0.0044]. In patients who also underwent cytoreductive therapy (n = 82), the mGPS decreased after chemotherapy in 22 patients (27%) and increased in 5 (6%). In these patients, the mGPS prior to cytoreductive therapy was an independent prognostic indicator of survival (OR 3.412; 95% CI 1.198–9.720; p = 0.0216), but the mGPS prior to chemotherapy was not. Conclusions: The mGPS is an independent prognostic indicator of survival in patients undergoing multimodality therapy for advanced CRC, if recorded at a relevant time point.

A Prognostic Indicator of Survival in Metastatic Colorectal Cancer Patients in the Era of Molecular-Targeted Agents: The Modified Glasgow Prognostic Score

“…The study by Inoue et al [1] reinforced previously published data from Forrest et al [9] who considered the GPS to be a useful stage-independent predictor for outcome of treatment, but failed to confirm such efficacy in the era of targeted agents.…”

“…We read with great interest the article by Inoue et al [1] identifying the usefulness of the modified Glasgow Prognostic Score (GPS) as an independent prognostic indicator of survival in patients undergoing multimodality therapy for advanced colorectal cancer (CRC). This biological score has proven its efficiency as a prognostic marker in metastatic CRC (mCRC) [2], in assessing the tolerance of systemic chemotherapy [3] and as a predictor of cancer-related death after surgery [4].…”

Surgical Stress Response After Colorectal Resection

“…[19][20][21][22] Most notably, GPS, modified GPS (mGPS), and the Prognostic Index have been associated with cancer survival.…”

The value of the pretreatment neutrophil lymphocyte ratio vs. platelet lymphocyte ratio in predicting the long-term survival in colorectal cancer

“…Many studies have shown that inflammation plays a significant role in dif-ferent stages of tumor growth like initiation, promotion, malignant conversion, invasion and metastasis [2][3][4]. Several systemic inflammatory response markers like C-reactive protein, albumin, interleukins, and tumor necrosis factors have been identified as prognostic indicators of adverse outcomes in colorectal cancer (CRC) patients [5,6]. Moreover, simple systemic inflammatory markers [e.g.…”