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Objective: To examine the relationship between the pre-operative systemic inflammatory response (modified Glasgow Prognostic Score, mGPS), the peritumoral inflammatory response (Klintrup score) and site of recurrence in patients undergoing curative resection for colorectal cancer.Background: Although known to have prognostic value, the pattern of disease recurrence associated with the mGPS and Klintrup score has not been examined.Methods: 291 patients between 1997 and 2007 were studied. mGPS was derived from routine preoperative blood tests. Routine pathology specimens were scored according to Klintrup criteria. Recurrence was defined as liver alone (intrahepatic), other sites (extrahepatic) and combined (intra- and extrahepatic).Results: Both the mGPS (HR 1.53, 1.19-1.97, p=0.001) and Klintrup score (HR 2.11, 1.23-3.63, p=0.007) were independently associated with 3 year recurrence free survival. However, only the mGPS was significantly associated with an intrahepatic site of recurrence (p<0.01). Of those patients with an intrahepatic recurrence, 66% had an elevated mGPS of 1 or 2. In contrast, 44% patients with extrahepatic recurrence had an elevated mGPS of 1 or 2 and 30% of patients with intra-and extrahepatic recurrence had an elevated mGPS of 1 or 2 (p<0.01). Conclusions: The results of the present study demonstrate that the modified Glasgow Prognostic Score is independently associated with the pattern of recurrence, to the liver in particular, in patients undergoing potentially curative resection for colorectal cancer. In contrast, the Klintrup score was not associated with any specific pattern of recurrence.