Abstract
The present study compared the prognostic value of the modified Glasgow prognostic score (mGPS) and high-sensitivity mGPS (HS-mGPS) in unresectable locally advanced esophageal squamous cell carcimona (LAESCC) patients treated with concurrent chemoradiotherapy (CCRT). The baseline data of 163 eligible patients were retrospectively collected. Patients with a C-reactive protein (CRP) ≤ 10 mg/l and albumin ≥ 35 g/l were allocated to mGPS-0 group. Patients with only elevated CRP (> 10 mg/l) were assigned to mGPS-1 group. Patients who had both elevated CRP (> 10 mg/l) and hypoalbuminurea (< 35 g/l) were assigned to mGPS-2 group. The HS-mGPS was calculated based on cutoff values of 3mg/l for CRP and the same value (35 g/l) for albumin. Prognostic significance for both tumor response and overall survival (OS) was analyzed by univariate and multivariate analysis. The mGPS was 0 in 95 patients, 1 in 28 patient and 2 in 40 patients. In contrast, the HS-mGPS was 0 in 66 patients, 1 in 47 patients and 2 in 50 patients. In multivariate analysis, the HS-mGPS was the only positive factor for tumor response (P = 0.015). Both the mGPS (P < 0.001) and HS-mGPS (P < 0.001) were good prognostic predictors for OS. However, the HS-mGPS was found to be a superior prognostic predictor compared to the mGPS in a multivariate analysis (P = 0.006). In conclusion, the pretreatment HS-mGPS is a strong prognosticator superior to the mGPS for both tumor response and OS in LAESCC patients who received CCRT.
Highlights
The HS-modified Glasgow prognostic score (mGPS) was found to be a superior prognostic predictor compared to the mGPS in a multivariate analysis (P = 0.006)
KaplanMeier survival analysis was performed to evaluate the differences in prognostic impact between mGPS
Increases in mGPS were correlated with unfavorable overall survival (OS) (0 vs. 1, P < 0.001; 0 vs. 2, P < 0.001; vs. 2, P = 0.006) (Figure 1A)
Summary
Predictive factors for the treatment response cutoff value: 35 mg/l) levels, which focusing on systemic inflammation and nutritional status in cancer patients. It has been validated as an independent prognostic factor in various malignancies including esophageal cancer [3]. There is a paucity of studies in the literature clarifying the prognostic effects of mGPS and HSmGPS in predicting treatment response and prognosis in unresectable LAESCC patients who received CCRT. Univariate analysis of predictive factors for the response to CCRT showed that mGPS (P = 0.005) and HS-mGPS (P = 0.001). Multivariate analysis identified HS-mGPS as the only independent predictive factor for ORR
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