Clinical Impact of Combined Modified Glasgow Prognostic Score and C-Reactive Protein/Albumin Ratio in Patients with Colorectal Cancer
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patient
2.2. Follow-Up Protocol
2.3. mGPS, CAR, and the Combination of These Two Parameters
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
Comparison of Clinicopathologic Factors According to mGPS
3.2. Cut-off Value of CAR
3.3. Combined Classification and Survival
3.4. Univariate Analysis
3.5. Multivariate Analysis
3.6. Time Dependent ROC among mGPS, CAR, and CC
3.7. Integrated AUC and C-Index Comparison among mGPS, CAR, and CC
3.8. Clinical Impact of Adding CC into AJCC Stage
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | mGPS 0 (n = 609) N (%) | mGPS 1 (n = 122) N (%) | mGPS 2 (n = 38) N (%) | p | |
---|---|---|---|---|---|
Sex | Female | 229 (37.6) | 38 (31.1) | 16 (42.1) | 0.316 |
Male | 380 (62.4) | 84 (68.9) | 22 (57.9) | ||
Age (years) | <70 | 428 (70.3) | 61 (50) | 18 (47.4) | <0.001 |
≥70 | 181 (29.7) | 61 (50) | 20 (52.6) | ||
ASA grade | 1 and 2 | 526 (86.4) | 97 (79.5) | 27 (71.1) | 0.041 |
3 and 4 | 54 (8.9) | 18 (14.8) | 8 (21.1) | ||
No data | 29 (4.8) | 7 (5.7) | 3 (7.9) | ||
BMI (kg/m2) | <25 | 414 (68) | 86 (70.5) | 28 (73.7) | 0.784 |
≥25 | 184 (30.2) | 35 (28.7) | 10 (26.3) | ||
No data | 11 (1.8) | 1 (0.8) | 0 | ||
CEA (ng/mL) | <5 | 422 (69.3) | 86 (70.5) | 18 (47.4) | 0.019 |
≥5 | 165 (27.1) | 35 (28.7) | 19 (50) | ||
No data | 22 (3.6) | 1 (0.8) | 1 (2.6) | ||
Tumor location | Colon | 393 (64.5) | 97 (79.5) | 35 (92.1) | <0.001 |
Rectum | 216 (35.5) | 25 (20.5) | 3 (7.9) | ||
Tumor size (cm) | <7 | 551 (90.5) | 89 (73) | 20 (52.6) | <0.001 |
≥7 | 58 (9.5) | 33 (27) | 18 (47.4) | ||
Histologic grade | G1 and G2 | 568 (93.3) | 108 (88.5) | 29 (76.3) | 0.003 |
G3 | 21 (3.4) | 6 (4.9) | 5 (13.2) | ||
Others | 20 (3.3) | 8 (6.6) | 4 (10.5) | ||
LVI | Absent | 453 (74.4) | 92 (75.4) | 26 (68.4) | 0.422 |
Present | 133 (21.8) | 29 (23.8) | 11 (28.9) | ||
No data | 23 (3.8) | 1 (0.8) | 1 (2.6) | ||
Complications | 128 (21) | 38 (31.1) | 12 (31.6) | 0.024 | |
Number of retrieved LNs | Mean (SD) | 22.4 (14.6) | 26 (15.4) | 26.8 (14.1) | 0.005 |
AJCC stage | I | 157 (25.8) | 20 (16.4) | 2 (5.3) | 0.001 |
II | 184 (30.2) | 47 (38.5) | 21 (55.3) | ||
III | 268 (44) | 55 (45.1) | 15 (39.5) | ||
Chemotherapy | 370 (60.8) | 74 (60.7) | 24 (63.2) | 0.956 | |
CAR | Mean (SD) | 0.1 (0.1) | 0.8 (0.8) | 1.7 (1.6) | <0.001 |
Variables | HR (95% CI) | p | |
---|---|---|---|
Sex | Female | 1 | |
Male | 1.54 (1.11–2.13) | 0.008 | |
Age (years) | <70 | 1 | |
≥70 | 3.51 (2.61–4.73) | <0.001 | |
ASA grade | 1 and 2 | 1 | |
3 and 4 | 1.29 (0.81–2.07) | 0.279 | |
No data | 0.91 (0.47–1.74) | 0.778 | |
BMI (kg/m2) | <25 | 1 | |
≥25 | 0.65 (0.46–0.93) | 0.018 | |
No data | 1.14 (0.42–3.09) | 0.793 | |
CEA (ng/mL) | <5 | 1 | |
≥5 | 1.90 (1.40–2.56) | <0.001 | |
No data | 1.25 (0.51–3.08) | 0.622 | |
Tumor location | Colon | 1 | |
Rectum | 0.91 (0.66–1.25) | 0.58 | |
Tumor size (cm) | <7 | 1 | |
≥7 | 1.46 (1.0–2.12) | 0.045 | |
Complications | No | 1 | |
Yes | 1.40 (1.02–1.94) | 0.037 | |
Histologic grade | G1 and G2 | 1 | |
G3 | 1.36 (0.69–2.67) | 0.364 | |
Others | 1.58 (0.86–2.92) | 0.139 | |
LVI | Absent | 1 | |
Present | 1.71 (1.24–2.36) | <0.001 | |
No data | 0.85 (0.34–2.09) | 0.732 | |
Number of retrieved LNs | <12 | 1 | |
≥12 | 0.65 (0.46–0.92) | 0.017 | |
AJCC stage | I | 1 | |
II | 2.04 (1.22–3.40) | 0.006 | |
III | 3.18 (1.97–5.13) | <0.001 | |
Chemotherapy | No | 1 | |
Yes | 0.78 (0.58–1.05) | 0.109 | |
mGPS | 0 | 1 | |
1 | 1.35 (0.92–1.96) | 0.118 | |
2 | 2.32 (1.38–3.90) | 0.001 | |
CAR | Low | 1 | |
High | 1.97 (1.47–2.64) | <0.001 | |
Combined classification | Group 1 | 1 | |
Group 2 | 2.43 (1.60–3.69) | <0.001 | |
Group 3 | 1.54 (1.04–2.27) | 0.028 | |
Group 4 | 2.65 (1.56–4.49) | <0.001 |
Variables | HR (95% CI) | p | |
---|---|---|---|
Sex | Female | 1 | |
Male | 1.41 (1.01–1.97) | 0.038 | |
Age (years) | <70 | 1 | |
≥70 | 3.21 (2.35–4.38) | <0.001 | |
BMI (kg/m2) | <25 | 1 | |
≥25 | 0.69 (0.49–0.99) | 0.045 | |
No data | 1.07 (0.38–2.97) | 0.886 | |
CEA (ng/mL) | <5 | 1 | |
≥5 | 1.43 (1.04–1.96) | 0.024 | |
No data | 2.22 (0.88–5.57) | 0.087 | |
Complications | No | 1 | |
Yes | 1.36 (0.98–1.90) | 0.063 | |
Number of retrieved LNs | <12 | 1 | |
≥12 | 0.54 (0.37–0.77) | <0.001 | |
AJCC stage | I | 1 | |
II | 1.93 (1.12–3.31) | 0.017 | |
III | 3.41 (2.04–5.69) | <0.001 | |
Combined classification | Group 1 | 1 | |
Group 2 | 1.47 (0.95–2.29) | 0.083 | |
Group 3 | 1.14 (0.76–1.70) | 0.504 | |
Group 4 | 1.90 (1.09–3.30) | 0.022 |
Stage | Stage + CC | |
---|---|---|
C-index (95% CI) (bootstrapped) | 0.615 (0.579–0.65) | 0.651 (0.612–0.689) |
p = 0.0056 |
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Son, W.; Shin, S.-J.; Park, S.H.; Lee, S.K.; Park, E.J.; Baik, S.H.; Lee, K.Y.; Kang, J. Clinical Impact of Combined Modified Glasgow Prognostic Score and C-Reactive Protein/Albumin Ratio in Patients with Colorectal Cancer. Diagnostics 2020, 10, 859. https://doi.org/10.3390/diagnostics10110859
Son W, Shin S-J, Park SH, Lee SK, Park EJ, Baik SH, Lee KY, Kang J. Clinical Impact of Combined Modified Glasgow Prognostic Score and C-Reactive Protein/Albumin Ratio in Patients with Colorectal Cancer. Diagnostics. 2020; 10(11):859. https://doi.org/10.3390/diagnostics10110859
Chicago/Turabian StyleSon, Woosung, Su-Jin Shin, Su Hyeong Park, Soo Kyung Lee, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, and Jeonghyun Kang. 2020. "Clinical Impact of Combined Modified Glasgow Prognostic Score and C-Reactive Protein/Albumin Ratio in Patients with Colorectal Cancer" Diagnostics 10, no. 11: 859. https://doi.org/10.3390/diagnostics10110859