Shiki Fujino1, Norikatsu Myoshi2,3, Kazuhiro Saso1, Msaru Sasaki1, Satoshi Ishikawa1, Yusuke Takahashi4, Masayoshi Yasui4, Masayuki Ohue4, Taishi Hata1, Chu Matsuda1, Tsunekazu Mizushima1, Masaki Mori5, Yuichiro Doki1. 1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. 2. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. nmiyoshi@gesurg.med.osaka-u.ac.jp. 3. Innovative Oncology Research and Regenerative Medicine, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 537-8511, Japan. nmiyoshi@gesurg.med.osaka-u.ac.jp. 4. Department of Surgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 537-8511, Japan. 5. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Abstract
PURPOSE: Inflammation and the nutritional and immunologic status are known to be associated with the prognosis of malignant tumors. We aimed to examine inflammation-nutrition scores and predict the prognosis of colorectal cancer (CRC) patients by integrating nutritional and immunologic factors and tumor stage. METHODS: This study investigated 511 patients with CRC from 2007 to 2013: 380 in a training set (TS) and 131 in a validation set (VS). The Osaka Prognostic Score (OPS) used comprised 1 point each for C-reactive protein > 1.0 mg/dL, albumin (< 3.5 g/dL), and lymphocyte count < 1600. Patients were classified according to the total points. The modified Glasgow Prognostic Score and the Prognostic Nutritional Index were also examined. A nomogram for predicting the disease-free survival (DFS) and overall survival (OS) was constructed based on the OPS and TNM stage. RESULTS: In the TS, a high OPS and high TNM stage were significant predictors of the DFS and OS. The C-indexes of the OPS for the DFS and OS were higher than those of other reported scoring systems. The C-index of the nomogram for the DFS was 0.762 in the TS and 0.675 in the VS. The C-index of the nomogram for the OS was 0.805 in the TS and 0.743 in the VS. CONCLUSION: Integrating the TNM stage and OPS accurately predicted the prognosis of patients with CRC.
PURPOSE: Inflammation and the nutritional and immunologic status are known to be associated with the prognosis of malignant tumors. We aimed to examine inflammation-nutrition scores and predict the prognosis of colorectal cancer (CRC) patients by integrating nutritional and immunologic factors and tumor stage. METHODS: This study investigated 511 patients with CRC from 2007 to 2013: 380 in a training set (TS) and 131 in a validation set (VS). The Osaka Prognostic Score (OPS) used comprised 1 point each for C-reactive protein > 1.0 mg/dL, albumin (< 3.5 g/dL), and lymphocyte count < 1600. Patients were classified according to the total points. The modified Glasgow Prognostic Score and the Prognostic Nutritional Index were also examined. A nomogram for predicting the disease-free survival (DFS) and overall survival (OS) was constructed based on the OPS and TNM stage. RESULTS: In the TS, a high OPS and high TNM stage were significant predictors of the DFS and OS. The C-indexes of the OPS for the DFS and OS were higher than those of other reported scoring systems. The C-index of the nomogram for the DFS was 0.762 in the TS and 0.675 in the VS. The C-index of the nomogram for the OS was 0.805 in the TS and 0.743 in the VS. CONCLUSION: Integrating the TNM stage and OPS accurately predicted the prognosis of patients with CRC.
Authors: M J Proctor; D S Morrison; D Talwar; S M Balmer; D S J O'Reilly; A K Foulis; P G Horgan; D C McMillan Journal: Br J Cancer Date: 2011-01-25 Impact factor: 7.640