Usefulness of a modified inflammation-based prognostic system for predicting postoperative mortality of patients
Mitsuru Ishizuka1, Keiichi Kubota, Junji Kita
1Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan. mm-ishizuka@umin.ac.jp
Insights
The hepatic Glasgow Prognostic Score (hGPS) better predicts postoperative mortality in liver cancer patients than the CLIP score. This score effectively categorizes patients, aiding in surgical outcome assessment.
Area of Science:
- Hepatobiliary Surgery
- Oncology
- Prognostic Biomarkers
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer.
- Accurate prognostic scoring is crucial for surgical decision-making in HCC.
- Existing scores like CLIP have limitations in predicting outcomes.
Purpose of the Study:
- To evaluate and compare the predictive accuracy of the hepatic Glasgow Prognostic Score (hGPS) and the Cancer of the Liver Italian Program (CLIP) score.
- To determine the utility of hGPS in stratifying surgical risk for primary HCC patients.
Main Methods:
- The hGPS was calculated based on C-reactive protein (CRP) levels and albumin status.
- Three hundred patients undergoing primary HCC surgery were analyzed.
- Predictive values of hGPS and CLIP scores for postoperative mortality were assessed.
Main Results:
- The hGPS successfully divided patients into three distinct risk groups.
- A hGPS of 2 significantly correlated with higher postoperative mortality (P < 0.001).
- The hGPS demonstrated superior predictive value for postoperative mortality compared to the CLIP score (P = 0.033).
Conclusions:
- The hGPS is a valuable tool for stratifying patients undergoing primary HCC surgery into independent prognostic groups.
- The hGPS is an important predictor of postoperative mortality in HCC surgical patients.
- hGPS offers improved predictive capability over the CLIP score for surgical HCC.
Objective:
To assess and compare the predictive values of the hepatic Glasgow Prognostic Score (hGPS) and Cancer of the Liver Italian Program (CLIP) score in patients undergoing surgery for primary hepatocellular carcinoma (HCC).
Methods:
The hGPS was calculated as follows: patients with an elevated level of C-reactive protein (CRP) (>0.3 mg/dl) were allocated a hGPS of 1 or 2 depending on the absence or presence of hypoalbuminemia (<3.5 g/dl), and patients without an elevation of the CRP level (≤ 0.3 mg/dl) were allocated a hGPS of 0.
Results:
Three hundred patients were evaluated. The hGPS divided patients into three independent groups, and that a hGPS of 2 predicted a higher mortality rate (P < 0.001) than a hGPS of 0 or 1. Univariate analysis demonstrated that hGPS (0, 1/2) (P = 0.010) was one of the factors predictive of postoperative mortality, along with the CLIP score (0, 1/≥ 2) (P = 0.021). Comparative analysis using these two factors showed that the hGPS was predictively superior to the CLIP score (P = 0.033).
Conclusions:
The hGPS is able to divide patients undergoing surgery for primary HCC into three independent groups, and is considered to be an important factor predictive of postoperative mortality in such patients.