Abstract
BackgroundElevated Glasgow Prognostic Score (GPS) has been related to poor prognosis in patients with hepatocellular carcinoma (HCC) undergoing surgical resection or receiving sorafenib. The aim of this study was to investigate the prognostic value of GPS in patients with various stages of the disease and with different liver functional status.MethodsOne hundred and fifty patients with newly diagnosed HCC were prospectively evaluated. Patients were divided according to their GPS scores. Univariate and multivariate analyses were performed to identify clinicopathological variables associated with overall survival; the identified variables were then compared with those of other validated staging systems.ResultsElevated GPS were associated with increased asparate aminotransferase (P<0.0001), total bilirubin (P<0.0001), decreased albumin (P<0.0001), α-fetoprotein (P=0.008), larger tumor diameter (P=0.003), tumor number (P=0.041), vascular invasion (P=0.0002), extra hepatic metastasis (P=0.02), higher Child-Pugh scores (P<0.0001), and higher Cancer Liver Italian Program scores (P<0.0001). On multivariate analysis, the elevated GPS was independently associated with worse overall survival.ConclusionsOur results demonstrate that the GPS can serve as an independent marker of poor prognosis in patients with HCC in various stages of disease and different liver functional status.
Highlights
Elevated Glasgow Prognostic Score (GPS) has been related to poor prognosis in patients with hepatocellular carcinoma (HCC) undergoing surgical resection or receiving sorafenib
Accumulating evidence indicates that the Glasgow Prognostic Score (GPS) system based on inflammation criteria and including only serum C-reactive protein (CRP) and albumin, is a reliant and practical scoring system for outcome prognostication in patients with advanced cancer, such as colorectal cancer [6,7], esophageal cancer [8], gastric cancer [9], pancreatic cancer [10], and lung cancer [11]
Eighty four (56%) patients were positive for antibodies to hepatitis C virus, 20 (13.3%) patients were positive for hepatitis B surface antigen (HBs Ag)
Summary
Elevated Glasgow Prognostic Score (GPS) has been related to poor prognosis in patients with hepatocellular carcinoma (HCC) undergoing surgical resection or receiving sorafenib. Hepatocellular carcinoma (HCC) is the seventh most common cancer worldwide, and the third leading cause of cancer-related deaths [1]. In contrast to other cancers, prognosis and treatment options for patients with HCC depend on the tumor progression and on the extent of liver dysfunction [2]. Accumulating evidence indicates that the Glasgow Prognostic Score (GPS) system based on inflammation criteria and including only serum C-reactive protein (CRP) and albumin, is a reliant and practical scoring system for outcome prognostication in patients with advanced cancer, such as colorectal cancer [6,7], esophageal cancer [8], gastric cancer [9], pancreatic cancer [10], and lung cancer [11]. It was based on the observation that hypoalbuminaemia without an elevated CRP concentration was rare and that hypoalbuminaemia on its own was not associated with poor survival [13]
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