Novel Preoperative Cancer-Specific Glasgow Prognostic Score Strongly Predicts Survival in Stage II/III Colorectal Cancer.

Abstract

OBJECTIVES: The Glasgow Prognostic Score (GPS), derived from serum C-reactive protein (CRP) and albumin (Alb) levels, is a validated prognostic marker in colorectal cancer (CRC). However, it lacks tumor-specific components. Carcinoembryonic antigen (CEA) is indicative of tumor burden and biology. To enhance prognostic stratification, we developed the Cancer-Specific Glasgow Prognostic Score (C-GPS), which integrates GPS with CEA. METHODS: We retrospectively analyzed 753 patients with Stage II/III CRC who underwent curative resection between 2008 and 2018. The C-GPS was calculated by assigning one point each for CEA >5.0 ng/mL, Alb <3.5 g/dL, and CRP >1.0 mg/dL. Patients were categorized into Low (0), Mid (1-2), and High (3) C-GPS groups. Survival outcomes were evaluated using Kaplan-Meier and Cox regression models, and prognostic discrimination was assessed using the concordance index (C-index). RESULTS: The 5-year disease-free survival (DFS) and overall survival (OS) rates were significantly lower in the High C-GPS group (62.1% and 72.7%, respectively; p<0.01). Multivariate analysis identified High C-GPS as an independent predictor of poor DFS (HR: 1.76, 95% CI: 1.01-3.10, p=0.049) and OS (HR: 1.30, 95% CI: 1.01-1.66, p=0.034). The C-GPS demonstrated superior prognostic discrimination compared to GPS for both DFS (C-index: 0.583 vs. 0.524) and OS (0.633 vs. 0.576). CONCLUSIONS: C-GPS is a simple and clinically feasible composite index that provides better prognostic accuracy than GPS by incorporating tumor burden, systemic inflammation, and nutritional status to stratify patients with CRC following curative surgery.

AI evidence extraction

Main findings

In a retrospective analysis of 753 Stage II/III colorectal cancer patients, a high Cancer-Specific Glasgow Prognostic Score (C-GPS; based on CEA, albumin, and CRP) was associated with significantly lower 5-year DFS and OS. High C-GPS was an independent predictor of poorer DFS (HR 1.76, 95% CI 1.01–3.10) and OS (HR 1.30, 95% CI 1.01–1.66), and showed higher C-index values than the traditional GPS for both DFS and OS.

Outcomes measured

• Disease-free survival (DFS)
• Overall survival (OS)
• Prognostic discrimination (C-index)

Limitations

• Retrospective design

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    },
    "population": "Patients with Stage II/III colorectal cancer undergoing curative resection (2008–2018)",
    "sample_size": 753,
    "outcomes": [
        "Disease-free survival (DFS)",
        "Overall survival (OS)",
        "Prognostic discrimination (C-index)"
    ],
    "main_findings": "In a retrospective analysis of 753 Stage II/III colorectal cancer patients, a high Cancer-Specific Glasgow Prognostic Score (C-GPS; based on CEA, albumin, and CRP) was associated with significantly lower 5-year DFS and OS. High C-GPS was an independent predictor of poorer DFS (HR 1.76, 95% CI 1.01–3.10) and OS (HR 1.30, 95% CI 1.01–1.66), and showed higher C-index values than the traditional GPS for both DFS and OS.",
    "effect_direction": "harm",
    "limitations": [
        "Retrospective design"
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    "peer_reviewed_likely": "yes",
    "keywords": [
        "colorectal cancer",
        "Glasgow Prognostic Score",
        "Cancer-Specific Glasgow Prognostic Score",
        "CEA",
        "CRP",
        "albumin",
        "prognosis",
        "disease-free survival",
        "overall survival",
        "C-index"
    ],
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