Abstract
Background: Systemic inflammation is a key factor in tumor growth. The Glasgow Prognostic Score (GPS) has a certain value in predicting the prognosis of lung cancer. However, these results still do not have a unified direction. Methods: A systematic review and meta-analysis were performed to investigate the relationship between GPS and the prognosis of patients with non-small cell lung cancer (NSCLC). We set patients as follows: GPS = 0 vs. GPS = 1 or 2, GPS = 0 vs. GPS = 1, GPS = 0 vs. GPS = 2. We collected the hazard ratio (HR) and the 95% confidence interval (CI). Results: A total of 21 studies were included, involving 7333 patients. We observed a significant correlation with GPS and poor OS in NSCLC patients (HRGPS=0 vs. GPS=1 or 2 = 1.62, 95% CI: 1.27–2.07, p ≤ .001; HRGPS=0 vs GPS=1 = 2.14, 95% CI:1.31–3.49, p ≤ .001; HRGPS=0 vs. GPS=2 = 2.64, 95% CI: 1.45–4.82, p ≤ .001). Moreover, we made a subgroup analysis of surgery and stage. The results showed that when divided into GPS = 0 group and GPS = 1 or 2 group, the effect of high GPS on OS was more obvious in surgery (HR = 1.79, 95% CI: 1.08–2.97, p = .024). When GPS was divided into two groups (GPS = 0 and GPS = 1 or 2), the III-IV stage, higher GPS is associated with poor OS (HR = 1.73, 95% CI: 1.43–2.09, p ≤ .001). In the comparison of GPS = 0 and GPS = 1 group (HR = 1.56, 95% CI: 1.05–2.31, p = .026) and the grouping of GPS = 0 and GPS = 2(HR = 2.23, 95% CI: 1.17–4.26, p = .015), we came to the same conclusion. Conclusion: For patients with NSCLC, higher GPS is associated with poor prognosis, and GPS may be a reliable prognostic indicator. The decrease of GPS after pretreatment may be an effective way to improve the prognosis of NSCLC.
Highlights
The burden of cancer morbidity and mortality is growing rapidly around the world
We observed a significant correlation with Glasgow Prognostic Score (GPS) and poor OS in Non-small cell lung cancer (NSCLC) patients (HRGPS=0 vs. GPS=1 or 2 = 1.62, 95% confidence interval (CI): 1.27–2.07, p ≤ .001; HRGPS=0 vs GPS=1 = 2.14, 95% CI:1.31–3.49, p ≤ .001; HRGPS=0 vs. GPS=2 = 2.64, 95% CI: 1.45–4.82, p ≤ .001)
The results showed that when divided into GPS = 0 group and GPS = 1 or 2 group, the effect of high GPS on OS was more obvious in surgery (HR = 1.79, 95% CI: 1.08–2.97, p = .024)
Summary
The burden of cancer morbidity and mortality is growing rapidly around the world. The number of new deaths from lung cancer was 1,796,144, accounting for 1/5 (18.0%) of cancer deaths in 2020 (1). Non-small cell lung cancer (NSCLC) is an important histological type of primary bronchogenic carcinoma, which is one of the most common malignant tumors, accounting for more than 80% of the total number of lung cancer cases (2, 3). The poor prognosis of patients with malignant tumors is often associated with immune-related systemic inflammatory response and malnutrition. In recent years, some prognostic markers based on inflammation and nutrition have been introduced, including Glasgow Prognostic Score (GPS) (7), Modified Glasgow prognosis score (MGPS) (8), C-reactive protein-albumin ratio (CRP/ALB, CAR) (9), Prognostic nutrition index (PNI) (10, 11) and advanced lung cancer inflammation index (ALI) (12, 13) to predict the prognosis and survival of patients with lung cancer. The Glasgow Prognostic Score (GPS) has a certain value in predicting the prognosis of lung cancer. These results still do not have a unified direction
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