Systemic Inflammatory Response Predicts Postoperative Outcome in Patients With Liver Metastases From Colorectal Cancer

Background: Few studies have investigated the Glasgow Prognostic Score (GPS) in patients with liver metastases from colorectal cancer (LM-CRC). Methods: The GPS was calculated as follows: patients with both an elevated level of CRP (> 10 mg/L) and hypoalbuminemia (Alb <35 g/L) were allocated a score of 2, and patients showing one or neither of these blood chemistry abnormalities were allocated a score of I or 0, respectively. Results: Ninety-three patients were evaluated retrospectively. Kaplan-Meier analysis and log rank test revealed that a higher GPS predicted a higher postoperative death (P < 0.0001). Univariate analysis revealed that sex, number of hepatectomy, number of tumors, synchronous lung metastasis and CRP were associated with postoperative death. Multivariate analysis revealed that number of hepatectomy (odds ratio, 3.193; 95% CI, 1.093-9.330; P = 0.0338). number of tumors (odds ratio, 2.946; 95% CI, 1.094-7.931; P = 0.0325), synchronous lung metastasis (odds ratio, 3.424; 95% CI, 1.055-11.11 P = 0.0404) and CRP (odds ratio, 4.509; 95% CI 1.313-15.49; P = 0.0167) were associated with postoperative death. Conclusions: GPS is able to classify patients with LM-CRC into three independent groups. Among the selected factors, CRP is considered an important and high sensitive predictor of postoperative death in such patients. J. Surg. Oncol. 2009; 100: 38-42. (C) 2009 Wiley-Liss, Inc.