Key result
Preoperative HS-GPS of 2 predicts ~164% higher mortality risk versus 0 in advanced colon cancer.
Why the study?
Preoperative GPS and mGPS reflect prognosis in curative colorectal cancer surgery, but reports evaluating long-term prognosis prediction using high-sensitivity mGPS (HS-GPS) were lacking.
Does preoperative HS-GPS predict overall survival and recurrence-free survival in patients with advanced resectable colon cancer?
Observational (n=595)
No
Does preoperative HS-GPS predict overall survival and recurrence-free survival in patients with advanced resectable colon cancer?
Hazard Ratio: 2.638 (95% CI 1.046–6.65)
p-value: p=0.04
While HS-GPS is an independent predictor of overall survival in advanced resectable colon cancer, the standard GPS may be a superior prognostic model.
HS-GPS independently predicts OS in resected colon cancer; leaves open whether it improves on GPS for routine risk stratification.
BACKGROUND: Several studies have demonstrated that the preoperative Glasgow prognostic score (GPS) and modified GPS (mGPS) reflected the prognosis in patients undergoing curative surgery for colorectal cancer. However, there are no reports on long-term prognosis prediction using high-sensitivity mGPS (HS-GPS) in colorectal cancer. Therefore, this study aimed to calculate the prognostic value of preoperative HS-GPS in patients with colon cancer. METHODS: A cohort of 595 patients with advanced resectable colon cancer managed at our institution was analysed retrospectively. HS-GPS, GPS, and mGPS were evaluated for their ability to predict prognosis based on overall survival (OS) and recurrence-free survival (RFS). RESULTS: In the univariate analysis, HS-GPS was able to predict the prognosis with significant differences in OS but was not superior in assessing RFS. In the multivariate analysis of the HS-GPS model, age, pT, pN, and HS-GPS of 2 compared to HS-GPS of 0 (2 vs 0; hazard ratio [HR], 2.638; 95% confidence interval [CI], 1.046-6.650; P = 0.04) were identified as independent prognostic predictors of OS. In the multivariate analysis of the GPS model, GPS 2 vs 0 (HR, 1.444; 95% CI, 1.018-2.048; P = 0.04) and GPS 2 vs 1 (HR, 2.933; 95% CI, 1.209-7.144; P = 0.017), and in that of the mGPS model, mGPS 2 vs 0 (HR, 1.51; 95% CI, 1.066-2.140; P = 0.02) were independent prognostic predictors of OS. In each classification, GPS outperformed HS-GPS in predicting OS with a significant difference in the area under the receiver operating characteristic curve. In the multivariate analysis of the GPS model, GPS 2 vs 0 (HR, 1.537; 95% CI, 1.190-1.987; P = 0.002), and in that of the mGPS model, pN, CEA were independent prognostic predictors of RFS. CONCLUSION: HS-GPS is useful for predicting the prognosis of resectable advanced colon cancer. However, GPS may be more useful than HS-GPS as a prognostic model for advanced colon cancer.
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Kasahara et al. (2022) conducted an observational in Advanced resectable colon cancer (n=595). High-sensitivity modified Glasgow prognostic score (HS-GPS) of 2 vs. HS-GPS of 0 was evaluated on Overall survival (OS) (HR 2.638, 95% CI 1.046-6.650, p=0.04). A preoperative high-sensitivity modified Glasgow prognostic score of 2 was an independent predictor of worse overall survival compared to a score of 0 (HR 2.638) in patients with advanced colon cancer.
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