Nutritional and Inflammatory Measures Predict Survival of Patients with Stage IV Colorectal Cancer

Abstract Background: This study aimed to evaluate the prognostic impact of nutritional and inflammatory measures (controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and modified Glasgow prognostic score (mGPS)) on overall survival (OS) in patients with stage IV colorectal cancer (CRC).Methods: Subjects were 996 patients with stage IV CRC who were referred to the National Cancer Center Hospital between 2001 and 2015. We retrospectively investigated correlations between OS and CONUT score, PNI, and mGPS. Multivariate analyses were performed using Cox proportional hazards regression models.Results: After adjusting for known factors (age, gender, BMI, ECOG performance status, location of primary tumor, CEA levels, histological type, M category, and prior surgical treatment), all three measures were found to be independent prognostic factors for OS in patients with stage IV CRC (CONUT score, p<0.001; PNI, p<0.001; mGPS, p<0.001). Significant differences in OS were found between low CONUT score (0/1) (n=614; 61%) and intermediate CONUT score (2/3) (n=276; 28%) (hazard ratio (HR)=1.20, 95% confidence interval (CI): 1.02-1.42, p=0.032), and intermediate CONUT score and high CONUT score (≥4) (n=106; 11%) (HR=1.30, 95% CI: 1.01-1.67, p=0.045). Significant differences in OS were found between mGPS=0 (n=633; 64%) and mGPS=1 (n=234; 23%) (HR=1.84, 95% CI: 1.54-2.19, p<0.001), but not between mGPS=1 and mGPS=2 (n=129; 13%) (HR=1.12, 95% CI: 0.88-1.41, p=0.349). Patients with low PNI (<48.0) (n=443; 44%) showed a significantly lower OS rate than those with high PNI (≥48.0) (n=553; 56%) (HR=1.39, 95% CI: 1.19-1.62, p<0.001).Conclusions: CONUT score, PNI, and mGPS were found to be independent prognostic factors for OS in patients with stage IV CRC, suggesting that nutritional and inflammatory status is a useful host-related prognostic indicator in stage IV CRC.

Download Full-text

Nutritional and inflammatory measures predict survival of patients with stage IV colorectal cancer

BMC Cancer ◽

10.1186/s12885-020-07560-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yasuyuki Takamizawa ◽

Dai Shida ◽

Narikazu Boku ◽

Yuya Nakamura ◽

Yuka Ahiko ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Stage Iv ◽

Cancer Center ◽

Prognostic Impact ◽

Stage Iv Colorectal Cancer ◽

Inflammatory Status ◽

Conut Score

Abstract Background This study aimed to evaluate the prognostic impact of nutritional and inflammatory measures (controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and modified Glasgow prognostic score (mGPS)) on overall survival (OS) in patients with stage IV colorectal cancer (CRC). Methods Subjects were 996 patients with stage IV CRC who were referred to the National Cancer Center Hospital between 2001 and 2015. We retrospectively investigated correlations between OS and CONUT score, PNI, and mGPS. Multivariate analyses were performed using Cox proportional hazards regression models. Results After adjusting for known factors (age, gender, BMI, ECOG performance status, location of primary tumor, CEA levels, histological type, M category, and prior surgical treatment), all three measures were found to be independent prognostic factors for OS in patients with stage (CONUT score, p < 0.001; PNI, p < 0.001; mGPS, p < 0.001). Significant differences in OS were found between low CONUT score (0/1) (n = 614; 61%) and intermediate CONUT score (2/3) (n = 276; 28%) (hazard ratio (HR) = 1.20, 95% confidence interval (CI): 1.02–1.42, p = 0.032), and intermediate CONUT score and high CONUT score (≥4) (n = 106; 11%) (HR = 1.30, 95% CI: 1.01–1.67, p = 0.045). Significant differences in OS were found between mGPS = 0 (n = 633; 64%) and mGPS = 1 (n = 234; 23%) (HR = 1.84, 95% CI: 1.54–2.19, p < 0.001), but not between mGPS = 1 and mGPS = 2 (n = 129; 13%) (HR = 1.12, 95% CI: 0.88–1.41, p = 0.349). Patients with low PNI (< 48.0) (n = 443; 44%) showed a significantly lower OS rate than those with high PNI (≥48.0) (n = 553; 56%) (HR = 1.39, 95% CI: 1.19–1.62, p < 0.001). Conclusions CONUT score, PNI, and mGPS were found to be independent prognostic factors for OS in patients with stage IV CRC, suggesting that nutritional and inflammatory status is a useful host-related prognostic indicator in stage IV CRC.

Download Full-text

Nutritional and Inflammatory Measures Predict Survival of Patients with Stage IV Colorectal Cancer

10.21203/rs.3.rs-39821/v4 ◽

2020 ◽

Author(s):

Yasuyuki Takamizawa ◽

Dai Shida ◽

Narikazu Boku ◽

Yuya Nakamura ◽

Yuka Ahiko ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Stage Iv ◽

Cancer Center ◽

Prognostic Impact ◽

Stage Iv Colorectal Cancer ◽

Inflammatory Status ◽

Conut Score

Abstract Background: This study aimed to evaluate the prognostic impact of nutritional and inflammatory measures (controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and modified Glasgow prognostic score (mGPS)) on overall survival (OS) in patients with stage IV colorectal cancer (CRC).Methods: Subjects were 996 patients with stage IV CRC who were referred to the National Cancer Center Hospital between 2001 and 2015. We retrospectively investigated correlations between OS and CONUT score, PNI, and mGPS. Multivariate analyses were performed using Cox proportional hazards regression models.Results: After adjusting for known factors (age, gender, BMI, ECOG performance status, location of primary tumor, CEA levels, histological type, M category, and prior surgical treatment), all three measures were found to be independent prognostic factors for OS in patients with stage IV CRC (CONUT score, p<0.001; PNI, p<0.001; mGPS, p<0.001). Significant differences in OS were found between low CONUT score (0/1) (n=614; 61%) and intermediate CONUT score (2/3) (n=276; 28%) (hazard ratio (HR)=1.20, 95% confidence interval (CI): 1.02-1.42, p=0.032), and intermediate CONUT score and high CONUT score (≥4) (n=106; 11%) (HR=1.30, 95% CI: 1.01-1.67, p=0.045). Significant differences in OS were found between mGPS=0 (n=633; 64%) and mGPS=1 (n=234; 23%) (HR=1.84, 95% CI: 1.54-2.19, p<0.001), but not between mGPS=1 and mGPS=2 (n=129; 13%) (HR=1.12, 95% CI: 0.88-1.41, p=0.349). Patients with low PNI (<48.0) (n=443; 44%) showed a significantly lower OS rate than those with high PNI (≥48.0) (n=553; 56%) (HR=1.39, 95% CI: 1.19-1.62, p<0.001).Conclusions: CONUT score, PNI, and mGPS were found to be independent prognostic factors for OS in patients with stage IV CRC, suggesting that nutritional and inflammatory status is a useful host-related prognostic indicator in stage IV CRC.

Download Full-text

Nutritional and Inflammatory Measures Predict Survival of Patients with Stage IV Colorectal Cancer

10.21203/rs.3.rs-39821/v1 ◽

2020 ◽

Author(s):

Yasuyuki Takamizawa ◽

Dai Shida ◽

Narikazu Boku ◽

Yuya Nakamura ◽

Yuka Ahiko ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Stage Iv ◽

Cancer Center ◽

Prognostic Impact ◽

Stage Iv Colorectal Cancer ◽

Inflammatory Status ◽

Conut Score

Abstract Background: The present study aimed to evaluate the prognostic impact of nutritional and inflammatory measures (controlling nutritional status (CONUT) score, prognostic nutritional index (PNI) and modified Glasgow prognostic score (mGPS)) on overall survival (OS) in patients with stage IV colorectal cancer (CRC).Methods: Subjects were 996 patients with stage IV CRC who were referred to the National Cancer Center Hospital between 2001 and 2015. We retrospectively investigated correlations between OS and CONUT score, PNI, and mGPS. Multivariate analyses were performed using Cox proportional hazards regression models.Results: After adjusting for known factors (age, gender, ECOG performance status, location of primary tumor, CEA levels, histological type, M category, and prior surgical treatment), all three measures were found to be independent prognostic factors for OS in patients with stage IV CRC (CONUT score, p<0.001; PNI, p<0.001; mGPS, p<0.001). Significant differences in OS were found between low CONUT score (0/1) (n=614; 61%) and intermediate CONUT score (2/3) (n=276; 28%) (hazard ratio (HR)=1.20, p=0.031), and intermediate CONUT score and high CONUT score (≥4) (n=106; 11%) (HR=1.30, p=0.044). For mGPS, significant differences in OS were found between mGPS=0 (n=633; 64%) and mGPS=1 (n=234; 23%) (HR=1.83, p<0.001), but not between mGPS=1 and mGPS=2 (n=129; 13%) (HR=1.13, p=0.319). Patients with low PNI (<48.0) (n=443; 44%) showed a significantly lower OS rate than those with high PNI (≥48.0) (n=553; 56%) (HR=1.33, p<0.001).Conclusions: CONUT score, PNI, and mGPS were found to be independent prognostic factors for OS in patients with stage IV CRC, suggesting that nutritional and inflammatory status is a useful host-related prognostic indicator in stage IV CRC.Trial registration: retrospectively registered

Download Full-text

Prognostic Impact of Macroscopic Complete Resection and Inflammatory Status for Colorectal Cancer With Peritoneal Dissemination

International Surgery ◽

10.9738/intsurg-d-18-00009.1 ◽

2018 ◽

Vol 103 (7-8) ◽

pp. 331-338

Author(s):

Satoru Yamaguchi ◽

Keisuke Ihara ◽

Yosuke Shida ◽

Haruka Yokoyama ◽

Hideo Ogata ◽

...

Keyword(s):

Colorectal Cancer ◽

Peritoneal Metastasis ◽

Peritoneal Dissemination ◽

Prognostic Score ◽

Case Series ◽

Glasgow Prognostic Score ◽

Carbohydrate Antigen ◽

Complete Resection ◽

Prognostic Impact ◽

Inflammatory Status

Objective: To clarify the appropriate treatment policy for colorectal cancer with peritoneal metastasis, case series were analyzed retrospectively. Summary of background data: The frequency of colorectal cancer and peritoneal dissemination occurring simultaneously is 4% to 7%. The prevention of peritoneal metastasis and the development of a strategy for cure are considered important factors in improving the treatment outcome of colorectal cancer. Methods: A total of 60 patients with colorectal cancer with peritoneal dissemination were enrolled in this study. Tumor and host condition characteristics and treatment regimens affecting patient survival were tested by using Kaplan-Meier survival analysis. Results: Histologic type, carbohydrate antigen 19-9, macroscopic complete resection, and Glasgow Prognostic Score were found to be independent prognostic factors for overall survival. Conclusions: Peritoneal carcinomatosis can result in better patient prognoses in patients with well-differentiated carcinoma, less peritoneal spread, low levels of tumor markers, and a low Glasgow Prognostic Score. In these patients, curative resection of peritoneal metastases followed by intensive chemotherapy might be effective.

Download Full-text

Modified Glasgow prognostic score in patients with incurable stage IV colorectal cancer

The American Journal of Surgery ◽

10.1016/j.amjsurg.2012.07.051 ◽

2013 ◽

Vol 206 (2) ◽

pp. 234-240 ◽

Cited By ~ 23

Author(s):

Tomokazu Kishiki ◽

Tadahiko Masaki ◽

Hiroyoshi Matsuoka ◽

Takaaki Kobayashi ◽

Yutaka Suzuki ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Stage Iv ◽

Stage Iv Colorectal Cancer ◽

Modified Glasgow Prognostic Score

Download Full-text

Prognostic impact of carcinoembryonic antigen and carbohydrate antigen 19-9 in stage IV colorectal cancer patients after R0 resection

Journal of Surgical Research ◽

10.1016/j.jss.2016.06.078 ◽

2016 ◽

Vol 205 (2) ◽

pp. 384-392 ◽

Cited By ~ 10

Author(s):

Shinya Abe ◽

Kazushige Kawai ◽

Soichiro Ishihara ◽

Hiroaki Nozawa ◽

Keisuke Hata ◽

...

Keyword(s):

Colorectal Cancer ◽

Carcinoembryonic Antigen ◽

Cancer Patients ◽

Stage Iv ◽

Carbohydrate Antigen ◽

R0 Resection ◽

Prognostic Impact ◽

Stage Iv Colorectal Cancer ◽

Colorectal Cancer Patients

Download Full-text

Prognostic Value of C-Reactive Protein, Glasgow Prognostic Score, and C-Reactive Protein-to-Albumin Ratio in Colorectal Cancer

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.637650 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jiahui Zhou ◽

Wene Wei ◽

Hu Hou ◽

Shufang Ning ◽

Jilin Li ◽

...

Keyword(s):

Colorectal Cancer ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Roc Curve ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Stage I ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein

Background: Emerging evidence suggests that inflammatory response biomarkers are predictive factors that can improve the accuracy of colorectal cancer (CRC) prognoses. We aimed to evaluate the prognostic significance of C-reactive protein (CRP), the Glasgow Prognostic Score (GPS), and the CRP-to-albumin ratio (CAR) in CRC.Methods: Overall, 307 stage I–III CRC patients and 72 colorectal liver metastases (CRLM) patients were enrolled between October 2013 and September 2019. We investigated the correlation between the pretreatment CRP, GPS, and CAR and the clinicopathological characteristics. The Cox proportional hazards model was used for univariate or multivariate analysis to assess potential prognostic factors. A receiver operating characteristic (ROC) curve was constructed to evaluate the predictive value of each prognostic score. We established CRC survival nomograms based on the prognostic scores of inflammation.Results: The optimal cutoff levels for the CAR for overall survival (OS) in all CRC patients, stage I–III CRC patients, and CRLM patients were 0.16, 0.14, and 0.25, respectively. Kaplan–Meier analysis and log-rank tests demonstrated that patients with high CRP, CAR, and GPS had poorer OS in CRC, both in the cohorts of stage I–III patients and CRLM patients. In the different cohorts of CRC patients, the area under the ROC curve (AUC) of these three markers were all high. Multivariate analysis indicated that the location of the primary tumor, pathological differentiation, and pretreatment carcinoembryonic antigen (CEA), CRP, GPS, and CAR were independent prognostic factors for OS in stage I–III patients and that CRP, GPS, and CAR were independent prognostic factors for OS in CRLM patients. The predictors in the prediction nomograms included the pretreatment CRP, GPS, and CAR.Conclusions: CRP, GPS, and CAR have independent prognostic values in patients with CRC. Furthermore, the survival nomograms based on CRP, GPS, and CAR can provide more valuable clinical significance.

Download Full-text