Glasgow prognostic score is related to blood transfusion requirements and post-operative complications in hepatic resection for hepatocellular carcinoma.

BACKGROUND Systemic inflammation before surgery, as evidenced by the Glasgow prognostic score (GPS), predicts postoperative complications and cancer-specific survival in various types of cancer. The aim of this study was to evaluate the significance GPS in hepatic resection for hepatocellular carcinoma (HCC). PATIENTS AND METHODS Sixty-six patients who underwent elective hepatic resections for HCC were include in the study. Patients were classified into three groups: GPS 0 [C-reactive protein (CRP)≤1.0 mg/dl and serum albumin ≥3.5 g/dl, n = 54], GPS 1 [CRP >1.0 mg/dl or serum albumin <3.5 g/dl, n = 11], and GPS 2 [CRP>1.0 mg/dl and serum albumin <3.5 g/dl, n = 1]. We retrospectively examined the association between GPS (0 or 1) and perioperative clinical variables and outcome. RESULTS In univariate analysis, GPS 0 patients had significantly better preoperative the retention rate of indocyanine green at 15 minutes (ICGR15) (p=0.0418), Child-Pugh classification (p = 0.0075) and model for end-stage liver disease score (p = 0.0007) than did GPS 1 patients. In multivariate analysis, blood loss and GPS 1 were independent risk factors for pulmonary complications (p = 0.0118 for blood loss, p = 0.0143 for GPS 1), red blood cell concentration transfusion (p = 0.0036 for blood loss, p = 0.0117 for GPS 1) and flesh frozen plasma transfusion (p = 0.0020 for blood loss, p = 0.0044 for GPS 1). Albumin product transfusion, duration of operation (p = 0.0478), blood loss (p = 0.0420) and GPS 1 (p = 0.0111) were independent risk factors. Disease-free and overall survival of GPS 0 and GPS 1 patients were comparable. CONCLUSION GPS reflects preoperative patient status, and is associated with blood transfusion and pulmonary complications in elective hepatic resection for HCC.