Significance of intra/post‐operative prognostic scoring system in hepatectomy for colorectal liver metastases

Abstract

Abstract Aim The prognostic impact of postoperative systemic inflammatory response using an intra/post‐operative prognostic scoring system in patients with colorectal liver metastases (CRLM) after hepatic resection had never been investigated previously. Methods In total, 149 patients who underwent hepatic resection for CRLM were analyzed retrospectively. Intra/post‐operative prognostic scoring was performed using the postoperative modified Glasgow Prognostic Score (mGPS) at the first visit, after discharge, or a month after surgery during hospitalization. We investigated the association between clinicopathologic variables and disease‐free survival or overall survival by univariate and multivariate analyses. Results The median evaluation period of postoperative mGPS was 30 (26‐36) days after hepatectomy. Seventy‐one patients (48%) were classified as postoperative day 30 mGPS 1 or 2. In multivariate analysis, an extrahepatic lesion (P = .02), multiple tumors (P = .05), and postoperative day 30 mGPS 1 or 2 (P < .01) were independent and significant predictors of disease‐free survival. Moreover, extrahepatic lesion (P = .04), and postoperative day 30 mGPS 1 or 2 (P = .02) were independent and significant predictors for overall survival. Patients with postoperative day 30 mGPS 1 or 2 had significantly more advanced tumors, more invasive surgery, and more chances of infectious postoperative complications than those with postoperative day 30 mGPS 0. Conclusion Postoperative systemic inflammatory response, as evidenced by intra/post‐operative prognostic scoring system using postoperative day 30 mGPS, was a strong predictor for outcomes in patients who underwent liver resection for CRLM.

Keywords

• colorectal liver metastases
• Glasgow Prognostic Score
• hepatic resection
• prognostic factor
• systemic inflammatory response