The prognostic value of combined measures of the systemic inflammatory response in patients with colon cancer: an analysis of 1700 patients
Menée à partir de données cliniques portant sur 1 780 patients atteints d'un cancer du côlon de stade TNM I à III, cette étude évalue la performance d'un système de score, utilisant le rapport neutrophiles-lymphocytes et le score mGPS (modified Glasgow Prognostic Score), pour prédire la survie des patients après une résection chirurgicale
Background : The pre-operative systemic inflammatory response (SIR) measured using an acute-phase-protein-based score (modified Glasgow Prognostic Score (mGPS)) or the differential white cell count (neutrophil–lymphocyte ratio (NLR)) demonstrates prognostic significance following curative resection of colon cancer. We investigate the complementary use of both measures to better stratify outcomes.
Methods : The effect on survival of mGPS and NLR was examined using uni/multivariate analysis (UVA/MVA) in patients undergoing curative surgery for colon cancer. The synergistic effect of these scores in predicting OS/CSS was examined using a Systemic Inflammatory Grade (SIG).
Results : One thousand seven hundred and eight patients with TNM-I–III colon cancer were included. On MVA both mGPS and NLR were significant for OS (HR 1.16/1.21, respectively). Three-year survival stratified by mGPS was 83–58%(TNM-I–III), 87–65%(TNM-II) and 75–49%(TNM-III), and by NLR was 84–62%(TNM-I–III), 88–69%(TNM-II) and 77-49%(TNM-III). When mGPS and NLR were combined to form an overall SIG 0/1/2/3/4, this stratified 3-year OS 88%/84%/76%/65%/60% and CSS 93%/90%/82%/73%/70%, respectively (both p < 0.001). SIG stratified OS 93–68%/82–48% and CSS 97–80%/86–58% in TNM Stage II/III disease, respectively (all p < 0.001).
Conclusions : The present study shows that the pre-operative SIR in patients undergoing curative surgery for colon cancer is best measured using a SIG utilising mGPS and NLR.
British Journal of Cancer , résumé, 2021