The Prognostic Values of Inflammatory Markers in Colorectal Cancer: A Prospective Study

Background: The Tumor-Node-Metastasis (TNM) classification system, currently the standard for identifying stages of colon cancer, is not able to adequately describe the entire prognostic variation between patients. Increasing evidence has demonstrated that the systemic inflammation is crucial in tumorigenesis and survival. The purpose of this study was to investigate the prognostic value of m-GPS and NLR as preoperative inflammatory markers for patients who underwent curative resection with colon cancer. Methods: A total of 210 patients with colon cancer who received curative resection treatment at single tertiary center were included in this retrospective study. The patients m-GPS and NLR values were obtained for cancer-specific survival (CSS) at five years. Survival analysis was performed using Kaplan–Meier survival curves and Cox proportional hazards methods. The main aim was to investigate the relationship of these inflammatory markers with long-term survival. Results An m-GPS of >0 was an independent predictor of CSS (HR = 3.92; 95% CI: 1.80–8.56; p = 0.001), while NLR did not remain significant on multivariable analysis (p = 0.044). Patients with m-GPS of 2 showed dramatically worse survival. Notably, the prognostic superiority of m-GPS was most evident in patients with stage II/III disease, and it may have a role as an adjunct to TNM staging for risk assessment. Conclusions: Our results suggest that m-GPS is a strong independent prognostic factor in CC, especially for stage II or III patients, for whom treatment can be difficult to decide. The implementation of inflammation markers, such as m-GPS, into the clinical decision-making could improve adjuvant therapy selection and the follow-up care of patients. We suggest that prospective validation studies be conducted to verify these findings.