Abstract
Abstract Background: There is some evidence that pre-treatment systemic inflammation may be associated with survival in patients with prostate cancer; however, it is unclear whether this is independent of grade and stage of cancer. We therefore investigated the role of inflammation-based prognostic scores, the modified Glasgow Prognostic Score (mGPS) and Neutrophil Lymphocyte Ratio (NLR), and their associations with Gleason grade and socioeconomic circumstances in patients with prostate cancer. Methods: Patients from a cohort, the Glasgow Inflammation Outcome Study, who had diagnosis of prostate cancer, were included in this study. The mGPS was constructed by combining C-reactive protein and albumin while NLR by calculating the ratio of neutrophils to lymphocytes. We estimated five-year relative survival using the age, gender and deprivation specific life tables and relative excess risk of death by mGPS and NLR categories after adjusting for age, socioeconomic circumstances and Gleason grade. Results: Eight hundred and ninety seven prostate cancer patients were identified; of those 422 (47%) died during a maximum follow up of 6.2 years. Systemic inflammation appeared to have significant prognostic value. The mGPS predicted poorer 5-year overall and relative survival independent of age, socioeconomic circumstances, disease grade and NLR. Raised mGPS also had a significant association with excess risk of death (mGPS 2: Relative Excess Risk = 2.41, 95% CI 1.37-4.23) among aggressive, clinically significant prostate cancer (Gleason grades 8-10). Similarly, age-specific analyses were also carried out and raised mGPS showed significantly higher risk of death among those with age <65 and 65-74 years at diagnosis. However, a non-significant increased risk of death was also observed among those age >75 years. Conclusions: The mGPS is a strong measure of systemic inflammation, when compared to NLR. Prostate cancer patients with a raised mGPS had significantly higher risk of death for overall as well high grade disease. Inflammation-based prognostic scores predict outcome in patients with prostate cancer and should be added to their routine clinical assessment. Keywords: mGPS, NLR, prostate cancer, prognosis, Gleason grade, systemic inflammation Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3639. doi:1538-7445.AM2012-3639
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