Preoperative change of modified Glasgow prognostic score after stenting predicts the long-term outcomes of obstructive colorectal cancer

Surg Today. 2020 Mar;50(3):232-239. doi: 10.1007/s00595-019-01862-1. Epub 2019 Aug 12.

Abstract

Purpose: Inflammation-based markers predict the long-term outcomes of various malignancies. We investigated the relationship between the modified Glasgow prognostic score (mGPS) and the long-term outcomes of obstructive colorectal cancer in patients who underwent self-expandable metallic colonic stent placement and subsequently received curative surgery.

Methods: We retrospectively analyzed 63 consecutive patients with pathological stage II and III obstructive colorectal cancer from 2013 to 2018. The mGPS was calculated before stenting and surgery, and the difference of the scores was defined as the d-mGPS.

Results: All d-mGPS = 2 patients were > 70 years of age (p = 0.01). Postoperative complications were more common in the preoperative mGPS = 2 group (p = 0.02). The postoperative hospital stay was significantly longer in the mGPS = 2 group (p = 0.007). Multivariate analyses revealed that d-mGPS was an independent prognostic factor for overall survival (OS) (hazard ratio [HR] = 9.18, p = 0.004) and cancer-specific survival (HR = 9.98, p = 0.01). Preoperative mGPS = 2 was significantly associated with poor OS (HR = 5.53, p = 0.04).

Conclusion: The results indicated that mGPS might serve as a valuable indicator of the immunonutritional status of preoperative patients, and a preoperative change of the status might affect the long-term outcomes of patients with obstructive colorectal cancer.

Keywords: Modified glasgow prognostic score; Obstructive colorectal cancer; Retrospective study; Self-expandable metallic stent.

MeSH terms

  • Aged
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / immunology
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Glasgow Outcome Scale*
  • Humans
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / surgery*
  • Neoplasm Staging
  • Nutritional Status
  • Predictive Value of Tests
  • Preoperative Period
  • Stents*
  • Time Factors