Systemic inflammation and outcome in 2295 patients with stage I-III colorectal cancer from Scotland and Norway: First results from the ScotScan Colorectal Cancer Group

Park, J. H. , Fuglestad, A. J., Køstner, A. H., Oliwa, A., Graham, J., Horgan, P. G. , Roxburgh, C. S.D. , Kersten, C. and McMillan, D. C. (2020) Systemic inflammation and outcome in 2295 patients with stage I-III colorectal cancer from Scotland and Norway: First results from the ScotScan Colorectal Cancer Group. Annals of Surgical Oncology, 27, pp. 2784-2794. (doi: 10.1245/s10434-020-08268-1) (PMID:32248375) (PMCID:PMC7334267)

Abstract

Background: Systemic inflammatory response (SIR) is an adverse prognostic marker in colorectal cancer (CRC) patients. The ScotScan Colorectal Cancer Group was established to examine how markers of the SIR differ between populations and may be utilised to guide prognosis. Patients and Methods: Patients undergoing resection of stage I–III CRC from two prospective datasets in Scotland and Norway were included. The relationship between the modified Glasgow Prognostic Score (mGPS; combination of C-reactive protein and albumin) and overall survival (OS) was examined. The relationship between OS, adjuvant chemotherapy regime and mGPS was examined in patients with stage III colon cancer. Results: A total of 2295 patients were included. Patients from Scotland were more inflamed despite controlling for associated characteristics using multivariate logistic regression or propensity score matching (OR 2.82, 95% CI 1.98–4.01, p < 0.001). mGPS had similar independent prognostic value in both cohorts (Scotland: HR 1.27, 95% CI 1.12–1.45; Norway: HR 1.23, 95% CI 1.01–1.49) and stratified survival independent of TNM group in the whole cohort. In patients with stage III colon cancer receiving adjuvant therapy, there appeared to be a survival benefit in systemically inflamed patients receiving oxaliplatin but not single-agent 5-fluorouracil or capecitabine. Conclusions: The SIR differs between populations from different countries; however prognostic value remains similar. The present study strongly supports the routine reporting of the mGPS in patients with CRC.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Park, Mr James and Horgan, Professor Paul and McMillan, Professor Donald and Graham, Dr Janet and Roxburgh, Professor Campbell
• Authors: Park, J. H., Fuglestad, A. J., Køstner, A. H., Oliwa, A., Graham, J., Horgan, P. G., Roxburgh, C. S.D., Kersten, C., and McMillan, D. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Annals of Surgical Oncology
• Publisher: Springer
• ISSN: 1068-9265
• ISSN (Online): 1534-4681
• Published Online: 04 April 2020
• Copyright Holders: Copyright © The Author(s) 2020
• First Published: First published in Annals of Surgical Oncology 27:2784-2794
• Publisher Policy: Reproduced under a Creative Commons license