Prognostic significance of a systemic inflammatory response in patients undergoing multimodality therapy for advanced colorectal cancer

Oncology. 2013;84(2):100-7. doi: 10.1159/000343822. Epub 2012 Nov 9.

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.

MeSH terms

  • Adenocarcinoma / mortality*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • C-Reactive Protein / metabolism
  • CA-19-9 Antigen / metabolism
  • Carcinoembryonic Antigen / metabolism
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / mortality*
  • Colorectal Neoplasms / therapy
  • Combined Modality Therapy / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation / diagnosis
  • Inflammation / etiology*
  • Inflammation / metabolism
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Serum Albumin / metabolism
  • Survival Rate

Substances

  • Biomarkers, Tumor
  • CA-19-9 Antigen
  • Carcinoembryonic Antigen
  • Serum Albumin
  • C-Reactive Protein