Influence of inflammation-based prognostic score on mortality of patients undergoing chemotherapy for far advanced or recurrent unresectable colorectal cancer.

BACKGROUND

Recent studies have revealed that the modified Glasgow Prognostic Score (mGPS), an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the mGPS in patients undergoing chemotherapy for far-advanced or recurrent unresectable colorectal cancer (AR-UCRC).

OBJECTIVE

To demonstrate the influence of the mGPS for prognostication of patients undergoing chemotherapy for AR-UCRC.

METHODS

The mGPS was calculated as follows: patients with an elevated level of CRP (>1.0 mg/dL) were allocated a mGPS of 1 or 2 depending on the absence or presence of hypoalbuminemia (<3.5 g/dL) and patients showing no elevated level of CRP (< or =1.0 mg/dL) were allocated a mGPS of 0. Prognostic significance was analyzed by Kaplan-Meier, univariate, and multivariate analyses.

RESULTS

One hundred twelve patients who had undergone chemotherapy for AR-UCRC with regimens such as FOLFIRI (5-fluorouracil/l-leucovorin/irinotecan hydrochloride) or FOLFOX (5-fluorouracil/oxialiplatin) were evaluated retrospectively. Kaplan-Meier analysis and log-rank test revealed that mGPS 2 predicted a higher risk of mortality than mGPS 0 or 1 (P < 0.0001). Univariate analyses revealed that the neutrophil ratio (P = 0.0411), CA 19-9 (P = 0.0473), CRP (P = 0.0477), albumin (P = 0.0043), and mGPS (0, 1/2) (P < 0.0001) were associated with mortality. Multivariate analyses using these 5 factors revealed that only mGPS (0, 1/2) (odds ratio: 6.071; 95% CI: 1.625-22.68; P = 0.0073) was an independent risk factor of mortality.

CONCLUSIONS

mGPS is an important and independent predictor of mortality in patients undergoing chemotherapy for AR-UCRC.