Background/Aims: Systemic inflammatory responses have been reported to be independent predictors of cancer-specific survival in colorectal cancer. The Glasgow Prognostic Score (GPS), which is an inflammation-based prognostic factor, is defined by the presence of elevated C-reactive protein and hypoalbuminemia. The purpose of this study was to estimate whether GPS can be a prognostic factor in patients undergoing curative surgery for colorectal cancers. Methods: We studied 166 patients with stage II (TNM classification) and 200 patients with stage III who had undergone curative surgery for colorectal cancer between 1999 and 2004. Univariate and multivariate analyses were performed to evaluate the relationship between clinicopathological factors and prognosis. Results: Among patients with stage II, location and GPS were independent factors on multivariate analysis. In particular, GPS was revealed to be the strongest factor in cancer-specific survival (HR: 7.43, 95% confidence interval, CI: 2.86–19.30, p < 0.0001). On the other hand, among patients with stage III, the number of metastatic lymph nodes was the only independent factor on multivariate analysis (HR: 1.14, 95% CI: 1.07–1.20, p < 0.0001). GPS was not a prognostic factor in cancer-specific survival in stage III. Conclusion: Among patients with stage II, GPS was predictive of cancer-specific survival.

1.
Kayama T, Wakao F, Sobue T, Katanoda K, Tsukuma H, Mikami H, Kitai A: Cancer statistics in Japan-2011. Tokyo, Foundation for Promotion of Cancer Research, 2011.
2.
McMillan DC, Crozier JE, Canna K, Angerson WJ, McArdle CS: Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis 2007;22:881–886.
3.
Graziano F, Cascinu S: Prognostic molecular markers for planning adjuvant chemotherapy trials in Dukes’ B colorectal cancer patients: how much evidence is enough? Ann Oncol 2003;14:1026–1038.
4.
Longo WE, Virgo KS, Johnson FE, Wade TP, Vernava AM, Phelan MA, Henderson WG, Daley J, Khuri SF: Outcome after proctectomy for rectal cancer in Department of Veterans Affairs Hospitals: a report from the National Surgical Quality Improvement Program. Ann Surg 1998;228:64–70.
5.
Heys SD, Walker LG, Deehan DJ, Eremin OE: Serum albumin: a prognostic indicator in patients with colorectal cancer. J R Coll Surg Edinb 1998;43:163–168.
6.
Longo WE, Virgo KS, Johnson FE, Oprian CA, Vernava AM, Wade TP, Phelan MA, Henderson WG, Daley J, Khuri SF: Risk factors for morbidity and mortality after colectomy for colon cancer. Dis Colon Rectum 2000;43:83–91.
7.
Nozoe T, Matsumata T, Kitamura M, Sugimachi K: Significance of preoperative elevation of serum C-reactive protein as an indicator for prognosis in colorectal cancer. Am J Surg 1998;176:335–338.
8.
Nielsen HJ, Christensen IJ, Sorensen S, Moesgaard F, Brunner N: Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group. Ann Surg Oncol 2000;7:617–623.
9.
McMillan DC, Canna K, McArdle CS: Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 2003;90:215–219.
10.
Ishizuka M, Nagata H, Takagi K, Horie T, Kubota K: Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer. Ann Surg 2007;246:1047–1051.
11.
Ishizuka M, Kita J, Shimoda M, Rokkaku K, Kato M, Sawada T, Kubota K: Systemic inflammatory response predicts postoperative outcome in patients with liver metastases from colorectal cancer. J Surg Oncol 2009;100:38–42.
12.
Sobin LH, Gospodarowicz MK, Wittekind Ch: TNM Classification of Malignant Tumours, ed 7. New York, Wiley-Blackwell, 2009, pp 100–105.
13.
Ishizuka M, Nagata H, Takagi K, Kubota K: Systemic inflammatory response Associated with distant metastasis of T1 or T2 colorectal cancer. Dig Dis Sci 2010;55:3181–3187.
14.
Balkwill F, Mantovani A: Inflammation and cancer: back to Virchow? Lancet 2001;357:539–545.
15.
ten Kate M, Holfland LJ, van Koetsveld PM, Johannes J, van Eijck CHJ: Pro-inflammatory cytokines affect pancreatic carcinoma cell. Endothelial cell interactions. JOP 2006;7:454–464.
16.
Canna K, McArdle PA, McMillan DC, McNicol AM, Smith GW, Mckee RF, McArdle CS: The relationship between tumour T-lymphocyte infiltration, the systemic inflammatory response and survival in patients undergoing curative resection for colorectal cancer. Br J Cancer 2005;92:651–654.
17.
Erlinger TP, Platz EA, Rifai N, Helzlsouer KJ: C-reactive protein and the risk of incident colorectal cancer. JAMA 2004;291:585–590.
18.
Gunter MJ, Stolzenberg-Solomon R, Cross AJ, Leitzmann MF, Weinstein S, Wood RJ, Virtamo J, Taylor PR, Albanes D, Sinha R: A prospective study of serum C-reactive protein and colorectal cancer risk in men. Cancer Res 2006;66:2483–2487.
19.
Wong VK, Malik HZ, Hamady ZZ, Mukhtar AAI, Gomez D, Prasad KR, Toogood GJ, Lodge JPA: C-reactive protein as a predictor of prognosis following curative resection for colorectal liver metastasis. Br J Cancer 2007;96:222–225.
20.
Dixon MR, Haukoos JS, Udani SM, Naghi JJ, Arnell TD, Kumar RR, Stamos MJ: Carcinoembryonic antigen and albumin predict survival in patients with advanced colon and rectal cancer. Arch Surg 2003;138:962–966.
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