Novel Preoperative Cancer-Specific Glasgow Prognostic Score Strongly Predicts Survival in Stage II/III Colorectal Cancer.

Journal of the anus, rectum and colon · 2026 · Harm · Low evidence

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HarmLow evidencePaper 2394

Study snapshot

PublicationJournal of the anus, rectum and colon · 2026

Study typecohort

Reported directionHarm

Evidence ratingLow

Abstract

OBJECTIVES: The Glasgow Prognostic Score (GPS), derived from serum C-reactive protein (CRP) and albumin (Alb) levels, is a validated prognostic marker in colorectal cancer (CRC). However, it lacks tumor-specific components. Carcinoembryonic antigen (CEA) is indicative of tumor burden and biology. To enhance prognostic stratification, we developed the Cancer-Specific Glasgow Prognostic Score (C-GPS), which integrates GPS with CEA. METHODS: We retrospectively analyzed 753 patients with Stage II/III CRC who underwent curative resection between 2008 and 2018. The C-GPS was calculated by assigning one point each for CEA >5.0 ng/mL, Alb <3.5 g/dL, and CRP >1.0 mg/dL. Patients were categorized into Low (0), Mid (1-2), and High (3) C-GPS groups. Survival outcomes were evaluated using Kaplan-Meier and Cox regression models, and prognostic discrimination was assessed using the concordance index (C-index). RESULTS: The 5-year disease-free survival (DFS) and overall survival (OS) rates were significantly lower in the High C-GPS group (62.1% and 72.7%, respectively; p<0.01). Multivariate analysis identified High C-GPS as an independent predictor of poor DFS (HR: 1.76, 95% CI: 1.01-3.10, p=0.049) and OS (HR: 1.30, 95% CI: 1.01-1.66, p=0.034). The C-GPS demonstrated superior prognostic discrimination compared to GPS for both DFS (C-index: 0.583 vs. 0.524) and OS (0.633 vs. 0.576). CONCLUSIONS: C-GPS is a simple and clinically feasible composite index that provides better prognostic accuracy than GPS by incorporating tumor burden, systemic inflammation, and nutritional status to stratify patients with CRC following curative surgery.

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecohort

Effect directionharm

PopulationPatients with Stage II/III colorectal cancer undergoing curative resection (2008–2018)

Sample size753

ExposureNot supplied

Evidence strengthLowConfidence: 86% · Peer reviewed: yes

Main findings

In a retrospective analysis of 753 Stage II/III colorectal cancer patients, a high Cancer-Specific Glasgow Prognostic Score (C-GPS; based on CEA, albumin, and CRP) was associated with significantly lower 5-year DFS and OS. High C-GPS was an independent predictor of poorer DFS (HR 1.76, 95% CI 1.01–3.10) and OS (HR 1.30, 95% CI 1.01–1.66), and showed higher C-index values than the traditional GPS for both DFS and OS.

Outcomes measured

Disease-free survival (DFS)
Overall survival (OS)
Prognostic discrimination (C-index)

Limitations

Retrospective design

View raw extracted JSON

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  "population": "Patients with Stage II/III colorectal cancer undergoing curative resection (2008–2018)",
  "sample_size": 753,
  "outcomes": [
    "Disease-free survival (DFS)",
    "Overall survival (OS)",
    "Prognostic discrimination (C-index)"
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  "main_findings": "In a retrospective analysis of 753 Stage II/III colorectal cancer patients, a high Cancer-Specific Glasgow Prognostic Score (C-GPS; based on CEA, albumin, and CRP) was associated with significantly lower 5-year DFS and OS. High C-GPS was an independent predictor of poorer DFS (HR 1.76, 95% CI 1.01–3.10) and OS (HR 1.30, 95% CI 1.01–1.66), and showed higher C-index values than the traditional GPS for both DFS and OS.",
  "effect_direction": "harm",
  "limitations": [
    "Retrospective design"
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  "evidence_strength": "low",
  "confidence": 0.86,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "colorectal cancer",
    "Glasgow Prognostic Score",
    "Cancer-Specific Glasgow Prognostic Score",
    "CEA",
    "CRP",
    "albumin",
    "prognosis",
    "disease-free survival",
    "overall survival",
    "C-index"
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}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.23922/jarc.2025-084
PubMed: 41623607

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