Influence of Inflammation-Based Prognostic Score on Mortality of Patients Undergoing Chemotherapy for Far Advanced or Recurrent Unresectable Colorectal Cancer

Abstract
Background: Recent studies have revealed that the modified Glasgow Prognostic Score (mGPS), an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the mGPS in patients undergoing chemotherapy for far-advanced or recurrent unresectable colorectal cancer (AR-UCRC). Objective: To demonstrate the influence of the mGPS for prognostication of patients undergoing chemotherapy for AR-UCRC. Methods: The mGPS was calculated as follows: patients with an elevated level of CRP (>1.0 mg/dL) were allocated a mGPS of 1 or 2 depending on the absence or presence of hypoalbuminemia (P < 0.0001). Univariate analyses revealed that the neutrophil ratio (P = 0.0411), CA 19–9 (P = 0.0473), CRP (P = 0.0477), albumin (P = 0.0043), and mGPS (0, 1/2) (P < 0.0001) were associated with mortality. Multivariate analyses using these 5 factors revealed that only mGPS (0, 1/2) (odds ratio: 6.071; 95% CI: 1.625–22.68; P = 0.0073) was an independent risk factor of mortality. Conclusions: mGPS is an important and independent predictor of mortality in patients undergoing chemotherapy for AR-UCRC.

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