Clinical Impact of Combined Modified Glasgow Prognostic Score and C-Reactive Protein/Albumin Ratio in Patients with Colorectal Cancer
Woo‐Sung Son, Su‐Jin Shin, Su Hyeong Park, Soo Kyung Lee, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
Abstract
The prognostic impact of the combination of the modified Glasgow prognostic score (mGPS) and C-reactive protein/albumin ratio (CAR) in colorectal cancer (CRC) is unclear. We aimed to investigate the clinical usefulness of this combination as a predictor of survival in CRC patients. We retrospectively evaluated 769 CRC patients who had undergone surgery between January 2006 and March 2014. The CAR and mGPS within 1 month postoperation were examined. The integrated area under the curve (iAUC) was compared among mGPS, CAR, and the combined classification (CC). The optimal CAR cut-off for discriminating overall survival was 0.14. Based on this cut-off, the mGPS 0 group was divided into the mGPS 0 with low CAR and the mGPS 0 with high CAR groups, whereas all mGPS 1 and 2 patients were classified into the high CAR group. CC was an independent prognostic factor, and its iAUC value (0.587, 95% CI 0.553-0.624) was superior to those of the mGPS (0.544, 95% CI 0.516-0.576) (bootstrap iAUC mean difference = 0.043; 95% CI = 0.015-0.072) and CAR (0.578, 95% CI 0.545-0.613) (bootstrap iAUC mean difference = 0.009; 95% CI = 0.002-0.017), respectively. In conclusion, the combination of mGPS and CAR has a synergistic effect and has a higher prognostic accuracy than mGPS or CAR alone in patients with CRC.