Prognostic Significance of a Systemic Inflammatory Response in Patients Undergoing Multimodality Therapy for Advanced Colorectal Cancer
Prognostic Significance of a Systemic Inflammatory Response in Patients Undergoing Multimodality Therapy for Advanced Colorectal Cancer
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DOI：
10.1159/000343822
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发表时间：
2013-01-01
期刊：
影响因子：
3.5
通讯作者：
Kusunoki, Masato
中科院分区：
文献类型：
--
作者：
Inoue, Yasuhiro;Iwata, Takashi;Kusunoki, Masato
目的：基于炎症的格拉斯哥预后评分（GPS）与多种癌症的预后相关。本研究调查了改良GPS（mGPS）是否可以预测接受综合治疗的晚期结直肠癌（CRC）患者的生存率。方法：我们纳入了245例接受化疗的晚期CRC患者。在一线化疗和细胞减灭治疗（包括二次手术和/或射频消融）之前记录mGPS。使用Kaplan-Meier、单变量和多变量分析来分析mGPS的预后意义。结果如下：在仅接受化疗的患者中（n = 163），化疗前的mGPS是生存的独立预后指标[比值比（OR）1.858; 95%置信区间（CI）1.213-2.846; p = 0.0044]。在同时接受细胞减灭治疗的患者中（n = 82），22例患者（27%）化疗后mGPS降低，5例患者（6%）升高。在这些患者中，细胞减灭治疗前的mGPS是生存的独立预后指标（OR 3.412; 95%CI 1.198-9.720; p = 0.0216），但化疗前的mGPS不是。结论：如果在相关时间点记录，mGPS是接受多药治疗的晚期CRC患者生存期的独立预后指标。版权所有（C）2012 S. Karger AG，巴塞尔
Objectives: The inflammation-based Glasgow Prognostic Score (GPS) is associated with outcome in a variety of cancers. This study investigated whether a modified GPS (mGPS) could predict survival in patients undergoing multimodality therapy for advanced colorectal cancer (CRC). Methods: We enrolled 245 patients with advanced CRC who received chemotherapy. The mGPS was recorded prior to first-line chemotherapy and to cytoreductive therapy including secondary surgery and/or radiofrequency ablation. The prognostic significance of the mGPS was analyzed using Kaplan-Meier, univariate, and multivariate analyses. Results: In patients who received chemotherapy alone (n = 163), the mGPS prior to chemotherapy was an independent prognostic indicator of survival [odds ratio (OR) 1.858; 95% confidence interval (CI) 1.213-2.846; p = 0.0044]. In patients who also underwent cytoreductive therapy (n = 82), the mGPS decreased after chemotherapy in 22 patients (27%) and increased in 5 (6%). In these patients, the mGPS prior to cytoreductive therapy was an independent prognostic indicator of survival (OR 3.412; 95% CI 1.198-9.720; p = 0.0216), but the mGPS prior to chemotherapy was not. Conclusions: The mGPS is an independent prognostic indicator of survival in patients undergoing multinnodality therapy for advanced CRC, if recorded at a relevant time point. Copyright (C) 2012 S. Karger AG, Basel