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

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.