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. 2010 Oct 26;103(9):1356-61.
doi: 10.1038/sj.bjc.6605919. Epub 2010 Sep 28.

The relationship between patient physiology, the systemic inflammatory response and survival in patients undergoing curative resection of colorectal cancer

C H Richards  1 , E F Leitch, P G Horgan, J H Anderson, R F McKee, D C McMillan
Affiliations

The relationship between patient physiology, the systemic inflammatory response and survival in patients undergoing curative resection of colorectal cancer

C H Richards et al. Br J Cancer. .

Abstract

Background: It is increasingly recognised that host-related factors may be important in determining cancer outcome. The aim was to examine the relationship between patient physiology, the systemic inflammatory response and survival after colorectal cancer resection.

Methods: Patients undergoing potentially curative resection of colorectal cancer were identified from a prospectively maintained database. Patient physiology was assessed using the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) criteria. The systemic inflammatory response was assessed using the modified Glasgow Prognostic Score (mGPS). Multivariate 5-year survival analysis was carried out with calculation of hazard ratios (HR).

Results: A total of 320 patients were included. During follow-up (median 74 months), there were 136 deaths: 83 colorectal cancer related and 53 non-cancer related. Independent predictors of cancer-specific survival were age (HR: 1.46, P<0.01), Dukes stage (HR: 2.39, P<0.001), mGPS (HR: 1.78, P<0.001) and POSSUM physiology score (HR: 1.38, P=0.02). Predictors of overall survival were age (HR: 1.64, P<0.001), smoking (HR: 1.52, P=0.02), Dukes stage (HR: 1.64, P<0.001), mGPS (HR: 1.60, P<0.001) and POSSUM physiology score (HR: 1.27, P=0.03). A relationship between mGPS and POSSUM physiology score was also established (P<0.006).

Conclusion: The POSSUM physiology score and the systemic inflammatory response are strongly associated and both are independent predictors of cancer specific and overall survival in patients undergoing potentially curative resection of colorectal cancer.

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Figures

Figure 1
Figure 1
The relationship between POSSUM physiology score and cancer-specific survival in patients undergoing potentially curative resection for colorectal cancer. Groups 1–4 are shown top to bottom (P<0.001; log-rank test).
Figure 2
Figure 2
The relationship between POSSUM physiology score overall survival in patients undergoing potentially curative resection for colorectal cancer. Groups 1–4 are shown top to bottom (P<0.001; log-rank test).
Figure 3
Figure 3
Graphic representation showing the relationship between mGPS and individual POSSUM physiological variables.
See this image and copyright information in PMC

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