Association of inflammatory status of patients with histopathological characteristics of colorectal tumors and perioperative transfusion requirements

Abstract

Glasgow Prognostic Score (GPS) is such an infl ammation-based factor, defi ned by the combination of the level of serum C-reactive protein (CRP) and albumin, which are indicators of systematic infl ammatory response and nutritional status. A higher score is associated with a worse prognosis of diff erent tumor sites. The score is based on the immunomodulatory and infl ammatory status found in patients with elevated CRP. We hypothesized that there is a correlation between GPS and histopathological tumor characteristics and GPS and perioperative administration of erythrocyte concentrates in patients undergoing curative tumor resection. We retrospectively revied the data of fi fty-one consecutive patient who underwent elective colorectal surgery. We extracted the values of preoperative C-reactive protein(CRP) and albumin and calculated the GPS. We correlated the histopathology of cancer and perioperative transfusion with the outcome. GPS 0 and 2 having a tumor localized in the colon, with GPS 1 in the rectum. T4 tumor stage had patients only in the group of GPS 2 which was statistically signifi cant from the GPS 0 group. The GPS was not associated with the presence of metastases in the lymph nodes, lymphatic and perineural invasions, while a statistically signifi cant diff erence was present comparing GPS with tumor deposits between GPS 0 and GPS 1 and GPS 0 and GPS 2. Transfusions were statistically signifi cantly higher in GPS 2 group compared to GPS 0 and 1. A higher GPS score is associated with the changes of immune status of the tumor environment which can aff ect the recurrence of the disease and survival. GPS should be considered when recommending the frequency of follow up and therapy after curative tumor resection. We have shown that there is an increased risk for perioperative blood consumption, which may independently result in a worse prognosis of the underlying disease.