DOI QR코드

DOI QR Code

New Prognostic Scoring System for Incurable Stage IV Colorectal Cancer

  • Kishiki, Tomokazu (Surgery, Kyorin University School of Medicine) ;
  • Masaki, Tadahiko (Surgery, Kyorin University School of Medicine) ;
  • Mastuoka, Hiroyoshi (Surgery, Kyorin University School of Medicine) ;
  • Abe, Nobustugu (Surgery, Kyorin University School of Medicine) ;
  • Mori, Toshiyuki (Surgery, Kyorin University School of Medicine) ;
  • Sugiyama, Masanori (Surgery, Kyorin University School of Medicine)
  • Published : 2016.03.07

Abstract

Background: Components of the systemic inflammatory response, combined to form inflammation-based prognostic scores (mGPS, NLR, PLR, PI, PNI) have been associated with overall survival. The aim of the present study was to compare various prognostic factors including many previously established parameters and such systemic inflammation-based prognostic scores in a series of incurable stage IV colorectal cancer (CRC) patients. Materials and Methods: Patients (n=167) with stage IV CRC undergoing surgical procedures between 2005 and 2013 were enrolled. Preoperatively (7-30 days before surgery), routine laboratory examinations were performed on the same day. We calculated scores using these data and analyzed the association with cancer specific survival (CSS) statistically. Results: Univariate analysis revealed significant associations between CSS and WBC, albumin, CRP, CEA values, mGPS, PNI, and PI values among preoperative factors. On multivariate analysis, high mGPS and high CEA independently predicted shorter CSS (p=0.001 and p=0.018). A new scoring system was constructed using mGPS and CEA. When patients were separated into three categorized using this system, the new score accurately predicted CSS (p < 0.001). Conclusions: The present study indicates that a new scoring system, consisting of mGPS and CEA, is a simple and useful tool in predicting the survival of patients with incurable stage IV CRC, and should be included in the routine assessment of these patients for decision making of appropriate treatment.

Keywords

Colorectal cancer;stage IV;GPS;CEA

References

  1. Baron JA, Sandler RS (2000). Nonsteroidal anti-inflammatory drugs and cancer prevention. Annu Rev Med, 51, 511-23. https://doi.org/10.1146/annurev.med.51.1.511
  2. Cho H, Hur HW, Kim SW, et al (2009). Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother, 58, 15-23. https://doi.org/10.1007/s00262-008-0516-3
  3. Crumley AB, McMillan DC, Mckernan M, et al (2006). An elevated c-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer. Br J Cancer, 94, 1568-71. https://doi.org/10.1038/sj.bjc.6603150
  4. Crumley AB, McMillanDC, McKernan M, et al (2006). Evaluation of an inflammation-based prognostic score in patients with inoperable gastoro-oesophageal cancer. Br J Cancer, 94, 637-41. https://doi.org/10.1038/sj.bjc.6602998
  5. Daugherty SE, Pfeiffer RM, Sigurdson AJ, et al (2011). Nonsteroidal antiinflammatory drugs and bladder cancer: a pooled analysis. Am J Epidemiol, 173, 721-30. https://doi.org/10.1093/aje/kwq437
  6. García-Rodríguez LA, Huerta-Alvarez C (2001). Reduced risk of colorectal cancer among long-term users of aspirin and nonaspirin nonsteroidal antiinflammatory drugs. Epidemiol, 12, 88-93. https://doi.org/10.1097/00001648-200101000-00015
  7. Kanda M, Fujii T, Kodera Y, et al (2011). Nutritional predictors of postoperative outcome in pancreatic cancer. Br J Surg, 98, 268-74. https://doi.org/10.1002/bjs.7305
  8. Kao SC, Pavlakis N, Harvie R, et al (2010). High blood neutrophil-to-lymphocyte ratio is an indicator of poor prognosis in malignant mesothelioma patients undergoing systemic therapy. Clin Cancer Res, 16, 5805-13. https://doi.org/10.1158/1078-0432.CCR-10-2245
  9. Kasymjanova G, MacDonald N, Agulnik JS, et al (2010). The predictive value of pre-treatment inflammatory markers in advanced non-small-cell lung cancer. Curr Oncol, 17, 52-8.
  10. Kishiki T, Masaki T, Matsuoka H, et al (2013). Modified glasgow prognostic score in patients with incurable stage IV colorectal cancer. Am J Surg, 206, 234-40. https://doi.org/10.1016/j.amjsurg.2012.07.051
  11. Kobayashi T, Kawakami M, Kara Y, et al (2014). Combined evaluation of the Glasgow prognostic score and carcinoembryonic antigen concentration prior to hepatectomy predicts postoperative outcomes in patients with liver metastasis from colorectal cancer. Hepatogastroenterol, 133, 1359-62
  12. Langman MJ, Cheng KK, Gilman EA, et al (2000). Effect of anti-inflammatory drugs on overall risk of common cancer: case-control study in general practice research database. BMJ, 320, 1642-6. https://doi.org/10.1136/bmj.320.7250.1642
  13. McMillan DC, Crozier JE, Canna K, et al (2007). Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis, 22, 881-6. https://doi.org/10.1007/s00384-006-0259-6
  14. Nozoe T, Kimura Y, Ishida M, et al (2002). Correlation of pre-operative nutritional condition with post-operative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol, 28, 396-400. https://doi.org/10.1053/ejso.2002.1257
  15. Nozoe T, Ninomiya M, Maeda T, et al (2010). Prognostic nutritional index: A tool to predict the biological aggressiveness of gastric carcinoma. Surg Today, 40, 440-3. https://doi.org/10.1007/s00595-009-4065-y
  16. Proctor MJ, Morrison DS, Talwar D, et al (2011). A comparison of inflammation-based prognostic scores in patients with cancer. A glasgow inflammation outcome study. Eur J Cancer, 47, 2633-41. https://doi.org/10.1016/j.ejca.2011.03.028
  17. Rosen SA, Buell JF, Yoshida A, et al (2000). Initial presentation with stage IV colorectal cancer: How aggressive should we be? Arch Surg, 4, 534-5.
  18. Sarraf KM, Belcher E, Raevsky E, et al (2009). Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg, 137, 425-8. https://doi.org/10.1016/j.jtcvs.2008.05.046
  19. Schmoll HJ, Van Cutsem E, Stein A, et al (2012). ESMO consensus guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making. Ann Oncol, 23, 2479-516. https://doi.org/10.1093/annonc/mds236
  20. Smith RA, Bosonnet L, Raraty M, et al (2009). Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg, 197, 466-72. https://doi.org/10.1016/j.amjsurg.2007.12.057
  21. Walsh SR, Cook EJ, Goulder F, et al (2005). Neutrophillymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol, 91, 181-4. https://doi.org/10.1002/jso.20329

Cited by

  1. Baseline and Postoperative C-reactive Protein Levels Predict Long-Term Survival After Lung Metastasectomy vol.26, pp.3, 2019, https://doi.org/10.1245/s10434-018-07116-7