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Erschienen in:

01.02.2014 | Hepatobiliary Tumors

Evaluation of Two Inflammation-Based Prognostic Scores in Patients with Resectable Gallbladder Carcinoma

verfasst von: Xiang-Song Wu, MD, Liu-Bin Shi, MD, PhD, Mao-Lan Li, MD, Qian Ding, MD, Hao Weng, MD, Wen-Guang Wu, MD, Yang Cao, MD, Run-Fa Bao, MD, Yi-Jun Shu, MD, Qi-Chen Ding, MD, Jia-Sheng Mu, MD, Jun Gu, MD, Ping Dong, MD, Ying-Bin Liu, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 2/2014

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Abstract

Background

Survival after surgery for gallbladder cancer is generally poor. A number of inflammation-based prognostic scores have been established to help predict survival after surgery for several types of cancer. The objective of this study was to analyze and compare the utility of two inflammation-based prognostic scores, the Glasgow prognostic score (GPS) and the neutrophil-to-lymphocyte ratio (NLR), for predicting survival in patients with gallbladder cancer after surgery with curative intent.

Methods

We retrospectively reviewed the medical records of 85 patients with histologically confirmed, resectable gallbladder carcinoma (GBC), who were to receive curative surgery in our department. Univariate and multivariate analyses were performed to evaluate the relationship between the variables to overall survival (OS).

Results

A significant difference was detected in OS in patients with low and high GPS and NLR scores. Univariate analyses using clinicopathological characteristics revealed that tumor differentiation; tumor invasion; lymph node metastasis; tumor, node, metastasis classification system stage; positive margin status; combined common bile duct resection; serum levels of C-reactive protein, albumin, carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen, and CA125; white blood cell count; and GPS and NLR were all associated with OS. Among these characteristics, multivariate analysis demonstrated that a high GPS was independently associated with poorer OS, together with tumor invasion, lymph node metastasis, and positive margin status.

Conclusions

GPS is superior to NLR with respect to its prognostic value for patients with GBC after surgery with curative intent. GPS is not only associated with tumor progression but is also an independent marker of poor prognosis.

Cobourn N, Cleary S, Tan J, et al. Surgery for gallbladder cancer: a population-based analysis. J Am Coll Surg. 2008;207:371–82.CrossRef

Wang JW, Peng SY, Li JT, et al. Identification of metastasis-associated proteins involved in gallbladder carcinoma metastasis by proteomic analysis and functional exploration of chloride intracellular channel 1. Cancer Lett. 2009;281:71–81.PubMedCrossRef

Liu YB, He XW, Wang JW, et al. Establishment of liver metastasis model of human gallbladder cancer and isolation of the subpopulation with high metastatic potential. Zhonghua Yi Xue Za Zhi. 2006;86:2117–21.PubMed

Quan Z, Gu J, Dong P, et al. Reactive oxygen species-mediated endoplasmic reticulum stress and mitochondrial dysfunction contribute to cirsimaritin-induced apoptosis in human gallbladder carcinoma GBC-SD cells. Cancer Lett. 2010;295:252–9.PubMedCrossRef

Dong P, Zhang Y, Gu J, et al. Wogonin, an active ingredient of Chinese herb medicine Scutellaria baicalensis, inhibits the mobility and invasion of human gallbladder carcinoma GBC-SD cells by inducing the expression of maspin. J Ethnopharmacol. 2011;137:1373–80.PubMedCrossRef

Dong P, He XW, Gu J, et al. Vimentin significantly promoted gallbladder carcinoma metastasis. Chin Med J (Engl). 2011;124:4236–44.PubMed

Zhang Z, Wang X, Wu W, et al. Effects of matrine on proliferation and apoptosis in gallbladder carcinoma cells (GBC-SD). Phytother Res. 2012;26:932–7.PubMedCrossRef

Tan Z, Li M, Wu W, et al. NLK is a key regulator of proliferation and migration in gallbladder carcinoma cells. Mol Cell Biochem. 2012;369:27–33.PubMedCrossRef

He XW, Cao HQ, Xu LP, et al. Establishment and characterization of serial subpopulations with highly metastatic potential via different metastatic routes. Zhonghua Yi Xue Za Zhi. 2011;91:1852–5.PubMed

10.

Batra Y, Pal S, Dutta U, et al. Gallbladder cancer in India: a dismal picture. J Gastroenterol Hepatol. 2005;20:309–14.PubMedCrossRef

11.

Bartlett DL, Fong Y, Fortner JG, et al. Long-term results after resection for gallbladder cancer. Implications for staging and management. Ann Surg. 1996;224:639–46.PubMedCrossRef

12.

Butte JM, Matsuo K, Gönen M, et al. Gallbladder cancer: differences in presentation, surgical treatment, and survival in patients treated at centers in three countries. J Am Coll Surg. 2011;212:50–61.PubMedCrossRef

13.

Cziupka K, Partecke LI, Mirow L, et al. Outcomes and prognostic factors in gallbladder cancer: a single-centre experience. Langenbecks Arch Surg. 2012;397:899–907.PubMedCrossRef

14.

Kobayashi A, Oda T, Fukunaga K, et al. Invasion of the hepatic artery is a crucial predictor of poor outcomes in gallbladder carcinoma. World J Surg. 2012;36:645–50.PubMedCrossRef

15.

Lee HJ, Lee K, Lee DG, et al. Chemokine (C–X–C motif) ligand 12 is associated with gallbladder carcinoma progression and is a novel independent poor prognostic factor. Clin Cancer Res. 2012;18:3270–80.PubMedCrossRef

16.

Yang XW, Yang J, Li L, et al. Analysis of the relationships between clinicopathologic factors and survival in gallbladder cancer following surgical resection with curative intent. PLoS One. 2012;7:e51513. doi:10.1371/journal.pone.0051513.

17.

Lim H, Seo DW, Park DH, et al. Prognostic factors in patients with gallbladder cancer after surgical resection: analysis of 279 operated patients. J Clin Gastroenterol. 2013;47:443–8.

18.

Nevin JE, Moran TJ, Kay S, et al. Carcinoma of the gallbladder: staging, treatment, and prognosis. Cancer. 1976;37:141–8.PubMedCrossRef

19.

Edge SB; American Joint Committee on Cancer; American Cancer Society. AJCC cancer staging handbook: from the AJCC cancer staging manual. 7th ed. New York: Springer; 2010.

20.

La Torre M, Nigri G, Cavallini M, et al. The Glasgow prognostic score as a predictor of survival in patients with potentially resectable pancreatic adenocarcinoma. Ann Surg Oncol. 2012;19:2917–23.PubMedCrossRef

21.

Kubota T, Hiki N, Nunobe S, et al. Significance of the inflammation-based Glasgow prognostic score for short- and long-term outcomes after curative resection of gastric cancer. J Gastrointest Surg. 2012;16:2037–44.PubMedCrossRef

22.

Ishizuka M, Nagata H, Takagi K, et al. Inflammation-based prognostic system predicts survival after surgery for stage IV colorectal cancer. Am J Surg. 2013;205:22–8.PubMedCrossRef

23.

Jeong JH, Lim SM, Yun JY, et al. Comparison of two inflammation-based prognostic scores in patients with unresectable advanced gastric cancer. Oncology. 2012;83:292–9.PubMedCrossRef

24.

He W, Yin C, Guo G, Jiang C, et al. Initial neutrophil lymphocyte ratio is superior to platelet lymphocyte ratio as an adverse prognostic and predictive factor in metastatic colorectal cancer. Med Oncol. 2013;30:439. doi:10.1007/s12032-012-0439-x.

25.

Azab B, Shah N, Radbel J, et al. Pretreatment neutrophil/lymphocyte ratio is superior to platelet/lymphocyte ratio as a predictor of long-term mortality in breast cancer patients. Med Oncol. 2013;30:432. doi:10.1007/s12032-012-0432-4.

26.

Forrest LM, McMillan DC, McArdle CS, et al. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable nonsmall-cell lung cancer. Br J Cancer. 2003;89:1028–30.PubMedCentralPubMedCrossRef

27.

Lien YC, Hsieh CC, Wu YC, et al. Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastrointest Surg. 2004;8:1041–8.PubMedCrossRef

28.

Crumley AB, McMillan DC, McKernan M, et al. Evaluation of an inflammation-based prognostic score in patients with inoperable gastrooesophageal cancer. Br J Cancer. 2006;94:637–41.PubMedCentralPubMed

29.

Scott HR, McMillan DC, Forrest LM, et al. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. Br J Cancer. 2002;87:264–7.PubMedCentralPubMedCrossRef

30.

Azab B, Bhatt V, Phookhan J, et al. Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol. 2012;19:217–24.PubMedCrossRef

31.

Regimbeau JM, Fuks D, Bachellier P, et al. Prognostic value of jaundice in patients with gallbladder cancer by the AFC-GBC-2009 study group. Eur J Surg Oncol. 2011;37:505–12.PubMedCrossRef

32.

Kao SC, Pavlakis N, Harvie R, et al. High blood neutrophil-to-lymphocyte ratio is an indicator of poor prognosis in malignant mesothelioma patients undergoing systemic therapy. Clin Cancer Res. 2010;16:5805–13.PubMedCrossRef

33.

Wenguang W, Xuefeng W, Zhiping Z, et al. Three-step method for lymphadenectomy in gastric cancer surgery: a single institution experience of 120 patients. J Am Coll Surg. 2011;212:200–8.PubMedCrossRef

34.

Kinoshita A, Onoda H, Imai N, et al. The Glasgow Prognostic Score, an inflammation based prognostic score, predicts survival in patients with hepatocellular carcinoma. BMC Cancer. 2013;13:52. doi:10.1186/1471-2407-13-52.

35.

Qian BZ, Li J, Zhang H, et al. CCL2 recruits inflammatory monocytes to facilitate breast-tumour metastasis. Nature. 2011;475:222–5.PubMedCentralPubMedCrossRef

36.

Tan W, Zhang W, Strasner A, et al. Tumour-infiltrating regulatory T cells stimulate mammary cancer metastasis through RANKL-RANK signalling. Nature. 2011;470:548–53.PubMedCentralPubMedCrossRef

37.

Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420:860–7.PubMedCentralPubMedCrossRef

38.

Mantovani A. Cancer: inflaming metastasis. Nature. 2009;457:36–7.PubMedCrossRef

39.

Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010;6:149–63.PubMedCrossRef

40.

Koike Y, Miki C, Okugawa Y, et al. Preoperative C-reactive protein as a prognostic and therapeutic marker for colorectal cancer. J Surg Oncol. 2008;98:540–4.PubMedCrossRef

41.

Jagdev SP, Gregory W, Vasudev NS, et al. Improving the accuracy of preoperative survival prediction in renal cell carcinoma with C-reactive protein. Br J Cancer. 2010;103:1649–56.PubMedCentralPubMedCrossRef

42.

Kobayashi T, Teruya M, Kishiki T, et al. Inflammation-based prognostic score, prior to neoadjuvant chemoradiotherapy, predicts postoperative outcome in patients with esophageal squamous cell carcinoma. Surgery. 2008;144:729–35.PubMedCrossRef

43.

McMillan DC, Elahi MM, Sattar N, et al. Measurement of the systemic inflammatory response predicts cancer specific and non-cancer survival in patients with cancer. Nutr Cancer. 2001;41:64–9.PubMed

44.

Gregory AD, Houghton AM. Tumor-associated neutrophils: new targets for cancer therapy. Cancer Res. 2011;71:2411–6.PubMedCrossRef

45.

Zhao JJ, Pan K, Wang W, et al. The prognostic value of tumor-infiltrating neutrophils in gastric adenocarcinoma after resection. PLoS One. 2012;7:e33655. doi:10.1371/journal.pone.0033655.

46.

Dunn GP, Old LJ, Schreiber RD. The immunobiology of cancer immunosurveillance and immunoediting. Immunity. 2004;21:137–48.PubMedCrossRef

47.

Morgan RA, Dudley ME, Wunderlich JR, et al. Cancer regression in patients after transfer of genetically engineered lymphocytes. Science. 2006;314:126–9.PubMedCentralPubMedCrossRef

48.

Kinoshita A, Onoda H, Imai N, et al. Comparison of the prognostic value of inflammation-based prognostic scores in patients with hepatocellular carcinoma. Br J Cancer. 2012;107:988–93.PubMedCentralPubMedCrossRef

Titel: Evaluation of Two Inflammation-Based Prognostic Scores in Patients with Resectable Gallbladder Carcinoma
verfasst von: Xiang-Song Wu, MD
Liu-Bin Shi, MD, PhD
Mao-Lan Li, MD
Qian Ding, MD
Hao Weng, MD
Wen-Guang Wu, MD
Yang Cao, MD
Run-Fa Bao, MD
Yi-Jun Shu, MD
Qi-Chen Ding, MD
Jia-Sheng Mu, MD
Jun Gu, MD
Ping Dong, MD
Ying-Bin Liu, MD, PhD
Publikationsdatum: 01.02.2014
Verlag: Springer US
Erschienen in: Annals of Surgical Oncology / Ausgabe 2/2014
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3292-z

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