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

• DOI: 10.1007/s00595-019-01862-1
• Publication Date: 2019-08-12T15:02:40Z
• Authors: Ryuichiro Sato; Masaya Oikawa; Tetsuya Kakita; Takaho Okada; Tomoya Abe; Takashi Yazawa; Haruyuki Tsuchiya; Naoya Akazawa; Masaki Sato; Tetsuya Ohira; Yoshihiro Harada; Haruka Okano; Kei Ito; Noriaki Ohuchi; Takashi Tsuchiya
• Keywords: Time Factors; Glasgow Outcome Scale; Nutritional Status; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Preoperative Period; Humans; Stents; Colorectal Neoplasms; Intestinal Obstruction; Aged; Neoplasm Staging

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.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.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).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.