Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan.
Anticancer Res. 2013 Dec;33(12):5567-73.
The need for palliative resection of asymptomatic primary tumor in patients with unresectable metastatic colorectal cancer (CRC) is still controversial. In order to identify predictors of survival after palliative resection, we investigated the correlations between clinicopathological factors, preoperative Glasgow prognostic score (GPS) and neutrophil-to-lymphocyte ratio (NLR), and survival.
A total of 94 patients were enrolled in the present study. The prognostic value of the clinicopathological factors, GPS and NLR were analyzed retrospectively.
A multivariate analysis revealed that both the GPS and NLR were independent predictors of survival along with the preoperative Eastern Cooperative Oncology Group performance status (PS) and extent of distant metastasis. We classified the patients using a combination of these factors, and categorized them into three risk groups. The median survival time was five months in the high-risk group, compared to 21.5 months in the intermediate-risk group and 37 months in the low-risk group.
Sub-classification based on the GPS, NLR, PS and extent of distant metastasis can classify patients into three independent groups. There may be no survival benefits associated with palliative resection in the high-risk group.
对于不可切除转移性结直肠癌(CRC)患者,无症状原发肿瘤的姑息性切除的需求仍存在争议。为了确定姑息性切除术后生存的预测因素,我们研究了临床病理因素、术前格拉斯哥预后评分(GPS)和中性粒细胞与淋巴细胞比值(NLR)与生存之间的相关性。
本研究共纳入 94 例患者。回顾性分析了临床病理因素、GPS 和 NLR 的预后价值。
多因素分析显示,GPS 和 NLR 与术前东部肿瘤协作组表现状态(PS)和远处转移程度一起是生存的独立预测因素。我们结合这些因素对患者进行分类,并将其分为三个风险组。高危组的中位生存时间为 5 个月,中危组为 21.5 个月,低危组为 37 个月。
基于 GPS、NLR、PS 和远处转移程度的亚分类可将患者分为三个独立的组。高危组姑息性切除可能没有生存获益。