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Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer

  • Donald C. McMillan
  • Joseph E. M. Crozier
  • Khalid Canna
  • Wilson J. Angerson
  • Colin S. McArdle
Original Article

Abstract

Background/aims

The aim of the study was to examine the value of the combination of an elevated C-reactive protein and hypoalbuminaemia (GPS) in predicting cancer-specific survival after resection for colon and rectal cancer.

Materials and methods

The GPS was constructed as follows: Patients with both an elevated C-reactive protein (>10 mg/l) and hypoalbuminaemia (<35 g/l) were allocated a score of 2. Patients in whom only one or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively.

Results

A GPS of 1 (n = 109) was mainly due to an elevated C-reactive protein concentration and the remainder due to hypoalbuminaemia. In those patients with a GPS of 1 due to hypoalbuminaemia (n = 16), the 3-year overall survival rate was 94% compared with 62% in those patients with a GPS of 1 due to an elevated C-reactive protein concentration (n = 93, p = 0.0094). Therefore, the GPS was modified such that patients with hypoalbuminaemia were assigned a score of 0 in the absence of an elevated C-reactive protein. On univariate analysis of those patients with colon and rectal cancer, the modified GPS (p < 0.0001) was significantly associated with overall and cancer specific survival. On univariate survival analysis of those patients with Dukes B colon and rectal cancer, the modified GPS (p < 0.01) was significantly associated with overall and cancer specific survival.

Conclusion

The results of the present study indicate that the GPS, before surgery, predicts overall and cancer-specific survival after resection of colon and rectal cancer.

Keywords

Colorectal cancer Surgery C-reactive protein Albumin Dukes stage Prognostic score Survival 

Notes

Acknowledgement

We gratefully acknowledge the assistance of the surgeons of the colorectal unit, Royal Infirmary, Glasgow.

Conflict of interest statement

None declared.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Donald C. McMillan
    • 1
  • Joseph E. M. Crozier
    • 1
  • Khalid Canna
    • 1
  • Wilson J. Angerson
    • 1
  • Colin S. McArdle
    • 1
  1. 1.University Department of SurgeryRoyal InfirmaryGlasgowUK

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