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Preoperative inflammatory response as prognostic factor of patients with colon cancer

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Abstract

Purpose

This study aimed to investigate the abilities of the modified Glasgow prognostic score (mGPS) and other inflammatory scores to predict recurrence-free survival (RFS) among patients with colon cancer (CC). In addition, we evaluated the abilities of the mGPS to predict recurrence of stage II disease and the efficacy of adjuvant chemotherapy (AC) for stage III disease.

Methods

This retrospective study evaluated 477 patients with stage I–III CC who underwent curative surgery. These patients were categorized as having a low mGPS (mGPS 0) or a high mGPS (mGPS 1–2).

Results

Patients in the high mGPS group had significantly poorer RFS than patients in the low mGPS group (p < 0.01). Multivariate analysis revealed that a high mGPS independently predicted poor RFS (p < 0.01). Among patients with stage II CC, multivariate analysis revealed that the independent predictors of poor RFS were pT4 status (p < 0.01) and a high mGPS (p = 0.04). Among patients with stage III CC, AC was not significantly associated with the 5-year RFS for patients with a low mGPS (p = 0.38), although AC significantly improved the 5-year RFS for patients with a high mGPS (p < 0.01).

Conclusion

The preoperative mGPS significantly predicted recurrence among patients with CC, even among patients with stage II CC. In addition, mGPS may provide valuable information regarding subgroups of patients with stage III CC who might benefit from AC.

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto-shi, Kyoto, Japan

    Daiki Matsubara, Tomohiro Arita, Masayoshi Nakanishi, Yoshiaki Kuriu, Yasutoshi Murayama, Michihiro Kudou, Katsutoshi Shoda, Toshiyuki Kosuga, Hirotaka Konishi, Ryo Morimura, Atsushi Shiozaki, Hisashi Ikoma, Takeshi Kubota, Hitoshi Fujiwara, Kazuma Okamoto & Eigo Otsuji

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  1. Daiki Matsubara
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Contributions

This study was designed by D.M., T.A., M.N., and E.O.; D.M. and T.A. performed statistical analyses. The clinical information and materials were collected and kept by T.A., M.N., Y.K., Y.M., M.K., K.S., T.K., H.K., R.M., A.S., H.I., T.K., H.F., and K.O.; D.M. and T.A. drafted the manuscript. M.N. edited and revised the manuscript. E.O. approved the final version of the manuscript.

Corresponding author

Correspondence to Tomohiro Arita.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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ESM 1

Supplemental Fig1 Survival analysis according to stage and mGPS. Kaplan-Meier curves of recurrence-free survival (RFS) were created for patients with pathological stage I disease (a, n = 233), stage II disease (b, n = 203), and stage III disease (c, n = 200). mGPS modified Glasgow prognostic score, HR hazard ratio, CI confidence interval.(PNG 2045 kb)

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Matsubara, D., Arita, T., Nakanishi, M. et al. Preoperative inflammatory response as prognostic factor of patients with colon cancer. Langenbecks Arch Surg 404, 731–741 (2019). https://doi.org/10.1007/s00423-019-01811-z

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  • DOI: https://doi.org/10.1007/s00423-019-01811-z

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