Significance of intra/post-operative prognostic scoring system in hepatectomy for colorectal liver metastases

Aim: The prognostic impact of postoperative systemic inflammatory response using an intra/post-operative prognostic scoring system in patients with colorectal liver metastases (CRLM) after hepatic resection had never been investigated previously. Methods: In total, 149 patients who underwent hepatic resection for CRLM were analyzed retrospectively. Intra/post-operative prognostic scoring was performed using the postoperative modified Glasgow Prognostic Score (mGPS) at the first visit, after discharge, or a month after surgery during hospitalization. We investigated the association between clinicopathologic variables and disease-free survival or overall survival by univariate and multivariate analyses. Results: The median evaluation period of postoperative mGPS was 30 (26-36) days after hepatectomy. Seventy-one patients (48%) were classified as postoperative day 30 mGPS 1 or 2. In multivariate analysis, an extrahepatic lesion (P =.02), multiple tumors (P =.05), and postoperative day 30 mGPS 1 or 2 (P <.01) were independent and significant predictors of disease-free survival. Moreover, extrahepatic lesion (P =.04), and postoperative day 30 mGPS 1 or 2 (P =.02) were independent and significant predictors for overall survival. Patients with postoperative day 30 mGPS 1 or 2 had significantly more advanced tumors, more invasive surgery, and more chances of infectious postoperative complications than those with postoperative day 30 mGPS 0. Conclusion: Postoperative systemic inflammatory response, as evidenced by intra/post-operative prognostic scoring system using postoperative day 30 mGPS, was a strong predictor for outcomes in patients who underwent liver resection for CRLM.