Clinical significance of preoperative Glasgow prognostic score in patients with colorectal cancer and synchronous peritoneal metastases

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2025-01-24 DOI:10.1002/ags3.12918

Kosuke Fujimoto, Fumikazu Koyama, Hirotoshi Kobayashi, Kenjiro Kotake, Masayasu Kawasaki, Yukihide Kanemitsu, Yusuke Kinugasa, Hideki Ueno, Kotaro Maeda, Takeshi Suto, Michio Itabashi, Kimihiko Funahashi, Heita Ozawa, Shingo Noura, Hideyuki Ishida, Masayuki Ohue, Tomomichi Kiyomatsu, Soichiro Ishihara, Keiji Koda, Hideo Baba, Kenji Kawada, Yojiro Hashiguchi, Takanori Goi, Yuji Toiyama, Naohiro Tomita, Eiji Sunami, Fumihiko Fujita, Jun Watanabe, Kenichi Hakamada, Goro Nakayama, Kenichi Sugihara, Yoichi Ajioka

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Abstract

Background

Chemotherapy is the typical choice for treating colorectal cancer with synchronous peritoneal metastases. Nonetheless, surgical resection may be chosen if the metastases are resectable. Unfortunately, there is no reliable preoperative or intraoperative prognostic indicator. This study aimed to determine the prognostic significance of the preoperative Glasgow prognostic score (GPS) in colorectal cancer patients with synchronous peritoneal metastases.

Methods

We conducted a prospective study on 143 patients with colorectal cancer and concurrent peritoneal metastases. Our analysis included prognostic factors, such as the GPS, using data from the institutional observational study by the Japanese Society for Cancer of the Colon and Rectum.

Results

The 3-year survival rates for the GPS0 or 1 and GPS2 groups were 32.7% and 14.3%, respectively, with a significantly worse prognosis in the GPS2 group (p = 0.003). Multivariate analysis identified GPS2 (p = 0.006) and the peritoneal cancer index (PCI) (p = 0.029) or the Japanese surgical peritoneal metastasis grade (p = 0.009) as independent poor prognostic factors. Additionally, the GPS0 or 1 group with total resection of peritoneal metastases had a significantly better prognosis than the non-resection group (p < 0.001); however, there was no difference between the GPS2 group with total peritoneal resection and the non-resection group (p = 0.713).

Conclusions

Preoperative GPS2 is an independent poor prognostic factor in patients with colorectal cancer and synchronous peritoneal metastases, and surgical resection does not improve prognosis in patients with GPS2. Preoperative GPSs may be used as indicators for surgical resection of synchronous peritoneal metastases.

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结直肠癌伴同步腹膜转移患者术前格拉斯哥预后评分的临床意义

背景化疗是治疗结直肠癌伴同步腹膜转移的典型选择。尽管如此，如果转移灶是可切除的，可以选择手术切除。不幸的是，没有可靠的术前或术中预后指标。本研究旨在确定术前格拉斯哥预后评分（GPS）在结直肠癌同步腹膜转移患者中的预后意义。方法对143例结直肠癌合并腹膜转移患者进行前瞻性研究。我们的分析包括预后因素，如GPS，使用的数据来自日本结直肠癌协会的机构观察性研究。结果GPS0组、gps1组和GPS2组3年生存率分别为32.7%和14.3%，GPS2组预后明显差（p = 0.003）。多因素分析发现GPS2 （p = 0.006）、腹膜癌指数（PCI）（p = 0.029）或日本手术腹膜转移分级（p = 0.009）是独立的不良预后因素。此外，GPS0或gps1组完全切除腹膜转移瘤的预后明显优于未切除组（p < 0.001）；GPS2腹膜全切除术组与未切除术组比较差异无统计学意义（p = 0.713）。结论术前GPS2是结直肠癌伴同步腹膜转移患者预后不良的独立因素，手术切除并不能改善GPS2患者的预后。术前gps可作为同步腹膜转移手术切除的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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