Nakagawa Kazuya, Tanaka Kuniya, Nojiri Kazunori, Kumamoto Takafumi, Takeda Kazuhisa, Ueda Michio, Endo Itaru
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan,
Ann Surg Oncol. 2014 May;21(5):1711-8. doi: 10.1245/s10434-013-3342-6. Epub 2014 Jan 23.
The inflammation-based Glasgow prognostic score (GPS) has been demonstrated to be prognostic for various tumors. We investigated the value of the modified GPS (mGPS) for the prognosis of patients undergoing curative resection for colorectal liver metastases (CRLM).
A total of 343 patients were enrolled onto this study. The mGPS was calculated as follows: mGPS-0, C-reactive protein (CRP) ≤10 mg/L; mGPS-1, CRP >10 mg/L and albumin ≥35 g/L; and mGPS-2, CRP >10 mg/L and albumin <35 g/L. Prognostic significance was retrospectively analyzed by univariate and multivariate analyses.
Of the 343 patients, 295 (86.0 %) were assigned to mGPS-0, 33 (9.6 %) to mGPS-1, and 15 (4.4 %) to mGPS-2. The median disease-free survival of patients with mGPS-0, -1, and -2 was 18.3, 15.5, and 5.2 months, respectively. The median cancer-specific survival (CSS) of patients with mGPS-0, -1, and -2 was 89.5, 62.2, and 25.8 months, respectively. The CSS of patients with mGPS-0 was significantly longer than that of patients with mGPS-2. Multivariate analysis revealed a significant association between cancer-related postoperative mortality and mGPS and carcinoembryonic antigen level.
The preoperative mGPS is a useful prognostic factor for postoperative survival in patients undergoing curative resection for CRLM.
基于炎症的格拉斯哥预后评分（GPS）已被证明对多种肿瘤具有预后价值。我们研究了改良GPS（mGPS）对接受结直肠癌肝转移（CRLM）根治性切除患者预后的价值。
本研究共纳入343例患者。mGPS的计算方法如下：mGPS-0，C反应蛋白（CRP）≤10mg/L；mGPS-1，CRP>10mg/L且白蛋白≥35g/L；mGPS-2，CRP>10mg/L且白蛋白<35g/L。通过单因素和多因素分析对预后意义进行回顾性分析。
343例患者中，295例（86.0%）被归类为mGPS-0，33例（9.6%）为mGPS-1，15例（4.4%）为mGPS-2。mGPS-0、-1和-2患者的无病生存期中位数分别为18.3个月、15.5个月和5.2个月。mGPS-0、-1和-2患者的癌症特异性生存期（CSS）中位数分别为89.5个月、62.2个月和25.8个月。mGPS-0患者的CSS显著长于mGPS-2患者。多因素分析显示，癌症相关的术后死亡率与mGPS和癌胚抗原水平之间存在显著关联。
术前mGPS是接受CRLM根治性切除患者术后生存的一个有用的预后因素。
