Fujimoto Kosuke, Koyama Fumikazu, Kobayashi Hirotoshi, Kotake Kenjiro, Kawasaki Masayasu, Kanemitsu Yukihide, Kinugasa Yusuke, Ueno Hideki, Maeda Kotaro, Suto Takeshi, Itabashi Michio, Funahashi Kimihiko, Ozawa Heita, Noura Shingo, Ishida Hideyuki, Ohue Masayuki, Kiyomatsu Tomomichi, Ishihara Soichiro, Koda Keiji, Baba Hideo, Kawada Kenji, Hashiguchi Yojiro, Goi Takanori, Toiyama Yuji, Tomita Naohiro, Sunami Eiji, Fujita Fumihiko, Watanabe Jun, Hakamada Kenichi, Nakayama Goro, Sugihara Kenichi, Ajioka Yoichi
Department of Surgery Nara Medical University Kashihara Japan.
Division of Endoscopy Nara Medical University Hospital Kashihara Japan.
Ann Gastroenterol Surg. 2025 Jan 24;9(4):750-760. doi: 10.1002/ags3.12918. eCollection 2025 Jul.
Chemotherapy is the typical choice for treating colorectal cancer with synchronous peritoneal metastases. Nonetheless, surgical resection may be chosen if the metastases are resectable. Unfortunately, there is no reliable preoperative or intraoperative prognostic indicator. This study aimed to determine the prognostic significance of the preoperative Glasgow prognostic score (GPS) in colorectal cancer patients with synchronous peritoneal metastases.
We conducted a prospective study on 143 patients with colorectal cancer and concurrent peritoneal metastases. Our analysis included prognostic factors, such as the GPS, using data from the institutional observational study by the Japanese Society for Cancer of the Colon and Rectum.
The 3-year survival rates for the GPS0 or 1 and GPS2 groups were 32.7% and 14.3%, respectively, with a significantly worse prognosis in the GPS2 group ( = 0.003). Multivariate analysis identified GPS2 ( = 0.006) and the peritoneal cancer index (PCI) ( = 0.029) or the Japanese surgical peritoneal metastasis grade ( = 0.009) as independent poor prognostic factors. Additionally, the GPS0 or 1 group with total resection of peritoneal metastases had a significantly better prognosis than the non-resection group ( < 0.001); however, there was no difference between the GPS2 group with total peritoneal resection and the non-resection group ( = 0.713).
Preoperative GPS2 is an independent poor prognostic factor in patients with colorectal cancer and synchronous peritoneal metastases, and surgical resection does not improve prognosis in patients with GPS2. Preoperative GPSs may be used as indicators for surgical resection of synchronous peritoneal metastases.
化疗是治疗伴有同步腹膜转移的结直肠癌的典型选择。尽管如此，如果转移灶可切除，也可选择手术切除。遗憾的是，目前尚无可靠的术前或术中预后指标。本研究旨在确定术前格拉斯哥预后评分（GPS）在伴有同步腹膜转移的结直肠癌患者中的预后意义。
我们对143例患有结直肠癌并伴有腹膜转移的患者进行了一项前瞻性研究。我们的分析纳入了预后因素，如GPS，使用了日本结直肠癌学会机构观察性研究的数据。
GPS为0或1组和GPS为2组的3年生存率分别为32.7%和14.3%，GPS为2组的预后明显更差（P = 0.003）。多因素分析确定GPS为2（P = 0.006）以及腹膜癌指数（PCI）（P = 0.029）或日本外科腹膜转移分级（P = 0.009）为独立的不良预后因素。此外，腹膜转移灶完全切除的GPS为0或1组的预后明显优于未切除组（P < 0.001）；然而，腹膜完全切除的GPS为2组与未切除组之间无差异（P = 0.713）。
术前GPS为2是伴有同步腹膜转移的结直肠癌患者独立的不良预后因素，手术切除并不能改善GPS为2患者的预后。术前GPS可作为同步腹膜转移手术切除的指标。
