Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer

Ann Surg. 2007 Dec;246(6):1047-51. doi: 10.1097/SLA.0b013e3181454171.


Objective: To investigate the significance of preoperative Glasgow prognostic score (GPS) for postoperative prognostication of patients with colorectal cancer.

Background: Recent studies have revealed that the GPS, 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 GPS in the field of colorectal surgery.

Methods: The GPS was calculated on the basis of admission data as follows: patients with an elevated level of both CRP (>10 mg/L) and hypoalbuminemia (Alb <35 g/L) were allocated a score of 2, and patients showing 1 or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. Prognostic significance was analyzed by univariate and multivariate analyses.

Results: A total of 315 patients were evaluated. Kaplan-Meier analysis and log-rank test revealed that a higher GPS predicted a higher risk of postoperative mortality (P < 0.01). Univariate analyses revealed that postoperative TNM was the most sensitive predictor of postoperative mortality (odds ratio, 0.148; 95% confidence interval, 0.072-0.304; P < 0.0001). Multivariate analyses using factors such as age, sex, tumor site, serum carcinoembryonic antigen, CA19-9, CA72-4, CRP, albumin, and GPS revealed that GPS (odds ratio, 0.165; 95% confidence interval, 0.037-0.732; P = 0.0177) was associated with postoperative mortality.

Conclusions: Preoperative GPS is considered to be a useful predictor of postoperative mortality in patients with colorectal cancer.

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood*
  • C-Reactive Protein / metabolism*
  • Carcinoembryonic Antigen / blood*
  • Colectomy / methods*
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation / blood*
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Male
  • Odds Ratio
  • Prognosis
  • Retrospective Studies
  • Survival Rate


  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • C-Reactive Protein