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Abstract
Glasgow prognostic score (GPS) has been reported to be an indicator of prognosis for various cancers. However, the relationship between GPS and colorectal cancers (CRC) remains unclear. A comprehensive search of Pubmed, Embase, Cochrane library, Web of Science, ChinaInfo and Chinese National Knowledge Infrastructure was performed to identify eligible studies, from which the risk of overall survival (OS) and cancer-specific survival (CSS) were extracted. A random-effect model was adopted to combine hazard ratio (HR) and 95% confidence interval (CI). 25 articles with a total of 5660 participants were included. The pooled results indicated that elevated GPS was associated with poor OS (HR = 2.83, 95%CI: 2.00–4.00, P < 0.01) and CSS (HR = 1.94, 95%CI: 1.51–2.49, P < 0.01). This correlation was confirmed both in primary operable and advanced inoperable patients. Increased GPS was also closely related to advanced tumour-node-metastasis (TNM) stage (odds ratio [OR] = 1.44, 95% CI: 1.010–2.065, P < 0.05) and elevated level of serum carcinoembryonic antigen (OR = 2.252, 95% CI: 1.508–3.362, P < 0.01). Subgroup analysis revealed a significant association between high GPS and poor survival outcome according to the factors of sample size, study of region and cut-off value of GPS level. These findings suggest that GPS may serve as a reliable predictive index for patients with CRC.
Highlights
Colorectal cancer (CRC) is the third most common cancer worldwide and accounts for 10% of all newly diagnosed cancers[1]
After screening the titles and abstracts, 73 full-text articles were assessed for further eligibility analysis. 48 of them were subsequently excluded as follows: 18 studies without sufficient data; 22 of overlapping populations; 8 of only documented with abstracts, comments or reviews
A ‘Korean treatment’ was discussed in one study conducted in Korea, and the remaining four studies focused on chemotherapy
Summary
Colorectal cancer (CRC) is the third most common cancer worldwide and accounts for 10% of all newly diagnosed cancers[1]. Glasgow Prognostic Score (GPS) is such an inflammation-based factor, defined by the combination of the level of serum C-reactive protein (CRP) and albumin, which are indicators of systematic inflammatory response and nutritional status respectively[7]. For patients with CRC, the GPS system was widely studied, but the results were controversial. Leitch and his colleagues[14] reported that GPS was an independent prognostic factor for CRC, while Son et al.[15] did not detect significant association www.nature.com/scientificreports/. This makes it rational to perform systematic evaluation of the correlation between GPS and prognosis of patients with CRC to further clarify its clinical significance
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