Improvement of High-sensitivity Inflammation-based Glasgow Prognostic Score by Gastrectomy Is a Favorable Prognostic Factor in Patients with Gastric Cancer

Aim: The aim of the present study was to clarify the efficacy of inflammation-based Glasgow prognostic score after surgery in patients with gastric cancer and to determine clinicopathological factors affecting score improvement. Patients and Methods: Participants in this retrospective study were 236 patients with gastric cancer who underwent gastrectomy at the Fukuoka University Hospital. The high-sensitivity inflammation-based Glasgow prognostic score (HS-GPS) (cut-off values: 0.3 mg/dl for C-reactive protein; 3.5 g/dl for albumin) were calculated before and 1 month after surgery, and correlated to clinicopathological parameters and prognosis after surgery. Results: HS-GPS was classified as normal (score 0) in 162 patients and abnormal (score 1 or 2) in 74 patients. Out of the 162 patients with normal HS-GPS before surgery, 62 showed abnormal HS-GPS after surgery, while 26 of the 74 patients with abnormal HS-GPS before surgery improved to normal HS-GPS postoperatively. Abnormal HS-GPS before (p<0.0001) and after (p=0.0002) surgery were unfavorable prognostic factors in univariate analysis. HS-GPS after surgery was an independent prognostic factor (p=0.0324) in multivariate analysis, but HS-GPS before surgery was not. In the subgroup with abnormal HS-GPS before surgery (but not normal HS-GPS before surgery), improved HS-GPS after surgery had favorable prognostic impact in both uni- (p=0.0039) and multivariate analyses (p=0.0032). Conclusion: HS-GPS after surgery may be a valuable prognostic factor in patients with gastric cancer. Supplemental therapy represented by adjuvant chemotherapy might be required for gastric cancer p showing no improvement in HS-GPS after gastrectomy.