Glasgow Prognostic Score In Patients Research Articles

Prognostic value of the Glasgow Prognostic Score for patients with metastatic renal cell carcinoma treated by cytoreductive nephrectomy.

The aim of the present study was to evaluate the prognostic significance of the Glasgow Prognostic Score (GPS) in metastatic renal cell carcinoma (mRCC) patients treated by cytoreductive nephrectomy (CN), and the accuracy of the GPS as a prognostic factor. We retrospectively analyzed the data of patients who underwent CN for mRCC between March 1984 and August 2015. In accordance with the GPS criteria, the patients were classified into three groups: GPS 0: C-reactive protein (CRP)≤1.0mg/dl and albumin≥3.5g/dl; GPS 1: CRP>1.0mg/dl or albumin<3.5g/dl; and GPS 2: CRP>1.0mg/dl and albumin<3.5g/dl. We enrolled 170 patients (72% male; median age 63.5years). Fifty-six (33%), 67 (39%), and 47 (28%) patients had a GPS of 0, 1, and 2, respectively. The median overall survivals after CN were 52.4, 19.1, and 8.9months for patients with a GPS of 0, 1, and 2, respectively (P<0.0001). In addition to the GPS, Eastern Cooperative Oncology Group performance status (ECOG-PS), Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification, histology, sarcomatoid change, clinical T stage, primary tumor size, number of metastatic organs, non-regional lymph node metastasis, and liver metastasis were included in the Cox hazards regression model. Multivariate analysis of these factors revealed that the GPS was an independent prognostic factor of overall survival (P<0.0001). Harrell's concordance index in the multivariate prognostic model based on ECOG-PS, MSKCC risk criteria, histology, sarcomatoid change, clinical T stage, primary tumor size, number of metastatic organs, non-regional lymph node metastasis, and liver metastasis was 0.609, which increased to 0.652 after the inclusion of the GPS. GPS represents an independent prognostic factor for patients who undergo CN for mRCC.

Prognostic Value of the Glasgow Prognostic Score or Modified Glasgow Prognostic Score for Patients with Colorectal Cancer Receiving Various Treatments: a Systematic Review and Meta-Analysis

Background/Aims: Increasing evidence indicates that the systemic inflammatory response plays a vital role in carcinogenesis. The Glasgow Prognostic Score or modified Glasgow Prognostic Score (GPS/mGPS) is a novel inflammatory indicator which consists of CRP and albumin. Here, we performed a meta-analysis to evaluate the prognostic value of the GPS/ mGPS in patients with colorectal cancer (CRC) and to assess its consistency in different CRC therapies. Methods: The electronic databases PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from inception through December 2017 for the association between the GPS/mGPS and clinical outcomes. Study characteristics and prognostic data were extracted from each relevant study. Overall survival (OS) and cancer-specific survival (CSS) were considered the primary outcomes, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. The quality of each study was pooled using the random-effects Mantel-Haenszel model. Finally, subgroup analyses were performed to detect the heterogeneity of different CRC treatments. Results: Thirty-four studies, with a combined total of 8834 patients, were eligible for this meta-analysis. Data on OS and CSS were available in 23 and 22 studies, respectively. By comparing the prognostic values of different levels of the GPS in CRC patients, the summary HRs for OS and CSS were 2.18 (95% CI 1.83-2.60) and 1.82 (95% CI 1.57-2.11), respectively. According to the different tumor stages, the subgroup analyses were stratified by different treatments, including curative or palliative therapy. The results robustly confirmed the prognostic role of the GPS/mGPS. Conclusion: Our results suggest that the GPS/mGPS is a novel and effective prognostic indicator for the OS and CSS of patients with CRC.

Prognostic significance of Glasgow prognostic score in patients with acute exacerbation of idiopathic pulmonary fibrosis.

The Glasgow prognostic score (GPS) reflects the host systemic inflammatory response and is a validated independent prognostic factor in lung cancer. We investigated GPS as a potential predictive factor of clinical outcomes in idiopathic pulmonary fibrosis (IPF) patients with acute exacerbation (AE). This was a retrospective study performed between January 2006 and March 2016 in Bucheon St. Mary's Hospital, The Catholic University of Korea. Overall, 327 admitted IPF patients were registered in the study. Patients with definite pneumonia at the time of admission, those with left-sided heart failure, pulmonary embolism and an identifiable cause of acute lung injury, and those whose albumin or C-reactive protein levels were not measured were excluded. A total of 66 patients hospitalized with IPF-AE were finally included. Median survival was 20.7 days and 29 (43.9%) patients died during hospitalization. The median length of overall survival (OS) was 26.0, 20.0 and 15.0 days for GPS-0, GPS-1 and GPS-2, respectively. There were significant differences in OS between GPS-0 and GPS-2 (P = 0.002). In a multivariate analysis performed using a Cox regression model, eosinopenia (P = 0.007), lower partial pressure of oxygen/fraction of inspired oxygen ratio (P = 0.014), and higher GPS (P = 0.006) were independent predictors of mortality. GPS can be helpful in predicting mortality in IPF patients with AE.

Prognostic role of Glasgow prognostic score in patients with colorectal cancer: evidence from population studies

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.

Modified glasgow prognostic score in patients with small-cell lung cancer.

Systemic inflammatory response, which represents the presence of cachexia, is observed often in patients with lung cancer. To evaluate the prognostic significance of the presence of a systemic inflammatory response in small cell lung cancer (SCLC) patients, a retrospective study using modified Glasgow prognostic Score (mGPS) was performed. This score is composed of serum albumin and C-reactive protein levels. All the patients with SCLC who were diagnosed in Tsukuba University Hospital, Tsukuba Medical Center Hospital and Mito Medical Center between April 1999 and July 2016 were included in this study. During the study period, 332 patients with SCLC were consecutively admitted to these hospitals. Among them, 54 (16.9%) had mGPS=1, and 73 (22.9%) had mGPS=2. Male sex, advanced stage, poor performance status and no chemotherapy were unfavorable prognostic factors in uni- and multivariate-analysis. In addition, the presence of a systemic inflammatory response was confirmed as an unfavorable prognostic factor. In patients with SCLC, an existing systemic inflammatory response adversely affected the outcome. The patient's extent of disease as well as medical conditions including systemic inflammatory response must be taken into consideration when deciding whether to offer a standard therapy that may increase treatment-associated mortality.

Significance of the Glasgow Prognostic Score for patients with colorectal liver metastasis

BackgroundSystemic inflammation and nutritional status are strongly associated with tumor progression. Inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS), reflect these states and are predictive in patients with several types of advanced cancers. The aim of this study was to evaluate the significance of GPS in patients with colorectal liver metastasis (CRLM). Patients and methodsStudy subjects were 134 patients with CRLM who underwent initial radical liver resection at Hiroshima University Hospital between January 2000 and December 2013. Univariate and multivariate analyses were performed to identify variables associated with overall and recurrence-free survival following liver resection in two groups based on GPS. ResultsThere was no significant relationship between overall survival and GPS. Recurrence-free survival was significantly poorer in patients with GPS 1–2 than in those with GPS 0 (p < 0.01). In multivariate analysis for recurrence-free survival, moderate histologic differentiation, carcinoembryonic antigen level ≥10 ng/mL, and GPS 1–2 were identified as independent prognostic factors. ConclusionWe suggest that GPS is an important predictor of recurrence following liver resection in patients with CRLM, and it should be considered one of the evaluation criteria for liver resection.

The modified Glasgow prognostic score in patients undergoing surgery for bone and soft tissue sarcoma

The prognostic significance of markers of the systemic inflammatory response in patients with soft tissue and bone sarcomas remains unclear. Therefore, the present study aimed to compare the prognostic value of markers of the systemic inflammatory response in patients undergoing surgery for primary soft tissue and bone sarcoma. Patients who underwent resection of primary soft tissue/bone sarcoma between 2008 and 2012 and had pre-operative measurements of the systemic inflammatory response [C-reactive protein, albumin, white cell, neutrophil, lymphocyte and platelet counts, and the combination of C-reactive protein and albumin (mGPS)] were included in the study (n=111). The majority of the patients were ≤50 years old (84%), were female (63%), had soft tissue sarcoma (62%), and had tumours >10cm (52%), mostly of high grade (85%). The median follow-up of survivors was 50 months (range 34-78); 24 (21%) developed local recurrence, 35 (31%) developed distant metastases and 30 (30%) died of their cancer. On univariate analysis, tumour size (P<0.001), tumour grade (P<0.001), C-reactive protein level (P<0.001), albumin level (P<0.001) and mGPS (P<0.001) were significantly associated with distant recurrence-free survival. On a multivariate analysis, only tumour size [hazard ratios (HR) 2.57, 95% confidence intervals (CI) 1.14-5.32, P<0.05], tumour grade (HR 7.01, 95% CI 0.94-52.17, P<0.10) and mGPS (HR 1.92, 95% CI 1.31-2.83, P<0.01) were independently associated with distant recurrence-free survival. On a multivariate analysis, only tumour size (HR 2.85, 95% CI 1.10-7.39, P<0.05) and the mGPS (HR 2.03, 95% CI 1.31-3.16, P<0.01) were independently associated with cancer-specific survival. The systemic inflammatory response, as evidenced by the mGPS, was an important independent predictor of recurrence-free survival and cancer-specific survival in patients undergoing surgery for bone and soft tissue sarcoma.

Clinical Significance of the Glasgow Prognostic Score in Patients with Gastrointestinal Stromal Tumors.

To assess the clinical utility of the Glasgow prognostic score (GPS) as a blood predictor of postoperative recurrence in patients with gastric gastrointestinal stromal tumors (GISTs). Twenty-nine patients with gastric GISTs undergoing gastrectomy were retrospectively reviewed. Patients were classified based on GPS criteria as follows: GPS of 2: elevated C-reactive protein (>1.0 mg/dl) and hypoalbuminemia (<3.5 g/dl), GPS of 1: one of these hematological abnormalities, and GPS of 0: neither elevated CRP nor hypoalbuminemia. The National Institutes of Health (NIH) classification for a risk stratification demonstrated that 3 (10.3%), 15 (51.7%), 5 (17.2%), and 6 (20.7%) patients were at very low, low, intermediate, and high risk, respectively, of disease recurrence. GPS criteria classified 24 (82.8%), five (17.2%), and no (0%) patients into GPS of 0, 1, and 2, respectively. Postoperative recurrence was identified in five patients (17.2%). Disease recurrence correlated with a risk stratification based on the NIH or GPS classification (p=0.004 and p=0.024, respectively). The GPS, as well as NIH classification, is a promising blood predictor of disease recurrence in patients with resectable gastric GISTs.

Predictive value of Glasgow prognostic score in patients with colorectal cancer undergoing laparoscopic radical resection

To investigate the predictive value of preoperative Glasgow prognostic score (GPS) for the postoperative complications and survival in patients with colorectal cancer (CRC) undergoing laparoscopic radical resection. This retrospective study was conducted in the Beijing Hospital between January 2009 and January 2012. A total of 228 patients with primary CRC undergoing laparoscopic radical resection were analyzed. The GPS was constructed based on routine preoperative blood tests of C-reactive protein and serum albumin. The patients were classified into three groups according to GPS (GPS 0, 1, 2 groups). Survival curves were described by the Kaplan-Meier method and compared by the Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the influence of GPS on prognosis in patients with CRC undergoing laparoscopic radical resection. Preoperative CRP level was increased in 48 cases (21.1%), and preoperative serum albumin level was decreased in 104 cases (45.6%) in the whole group. These 228 patients were classified into 99, 105 and 24 patients in GPS 0, 1, 2 group respectively. GPS was significantly associated with age, preoperative body mass index (BMI), carcinoembryonic antigen (CEA), CA19-9, tumor location, tumor differentiation and TNM stage (all P<0.05). Postoperative complication rates of GPS 0, 1, 2 group were 6.1%, 14.3% and 70.8% respectively (χ2=59.147, P=0.000). Serious postoperative complication rates were 3.0%, 6.7% and 58.3% respectively (χ2=65.807, P=0.000). Univariate and multivariate analyses revealed that GPS was an independent risk factor of postoperative complications(HR=21.611, 95%CI: 5.936-78.681, P=0.000) and severe complications (HR=35.833, 95%CI: 7.364-174.355, P = 0.000). The 5-year survival rate was 50% and the average total survival time was 58.2 (95% CI: 54.6-61.7) months in the whole group. The median overall survival time in GPS 0, 1, 2 group was 74.6(95%CI: 70.4-78.7) months, 49.8(95%CI: 45.2-54.4) months and 27.8 (95%CI: 21.8-33.8) months respectively(χ2=98.425, P=0.000). The median disease-free survival time was 73.9(95%CI: 69.2-78.7) months, 47.4 (95% CI: 41.6-53.1) months and 19.9 (95%CI: 14.8-25.0) months respectively (χ2=91.305, P=0.000). GPS was an independent risk factor of disease-free survival (HR=4.840, 95%CI: 2.413-9.709, P=0.000) and overall survival (HR=6.267, 95%CI: 3.073-12.784, P=0.000). GPS can be used as an effective predictor of the prognosis for patients with CRC undergoing laparoscopic radical surgery. Higher GPS suggests more postoperative complications and worse prognosis.

Prognostic value of the Glasgow prognostic score in patients with pancreatic ductal adenocarcinoma after surgical resection

Prognostic value of the Glasgow prognostic score in patients with pancreatic ductal adenocarcinoma after surgical resection

Prognostic significance of modified Glasgow Prognostic Score in patients with non-metastatic clear cell renal cell carcinoma

Objective The aim of this study was to evaluate the usefulness of the modified Glasgow Prognostic Score (mGPS) as a prognostic factor in patients with non-metastatic clear cell renal cell carcinoma (RCC).Materials and methods Between June 1994 and July 2012, 469 patients with RCC underwent radical or partial nephrectomy at two hospitals. Among these patients, 65 with non-clear cell type histology and 16 with lymph-node or distant metastasis were excluded. The medical records of the remaining 388 patients were retrospectively reviewed. The mGPS was calculated using a selective combination of C-reactive protein (CRP) and albumin as previously described. The prognostic significance of various clinicopathological variables including mGPS was analyzed using univariate and multivariate analyses.Results Of the total 388 patients, 40 patients (10.3%) developed local recurrence or distant metastasis and 18 patients (4.6%) died of disease during the follow-up period. The univariate analysis identified CRP, mGPS, thrombocytosis, T stage, Fuhrman’s nuclear grade and lymphovascular invasion as significant prognostic factors for recurrence-free survival (RFS) and cancer-specific survival (CSS). The multivariate analysis indicated that mGPS (p < 0.001), T stage (p = 0.024) and lymphovascular invasion (p = 0.046) were independent prognostic factors for RFS, whereas mGPS (p = 0.001) was the only independent prognostic factor for CSS.Conclusions The mGPS is an independent prognostic factor for RFS and CSS in patients with non-metastatic clear cell RCC treated with radical or partial nephrectomy. These findings suggest that mGPS should be used for predicting recurrence or survival in patients undergoing nephrectomy for non-metastatic clear cell RCC.

Prognostic impact of the high-sensitivity modified Glasgow prognostic score in patients with resectable non-small cell lung cancer.

The present study compared the prognostic value of the Glasgow prognostic score (GPS), modified GPS (mGPS), high-sensitivity mGPS (HS-mGPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), prognostic index (PI), and prognostic nutritional index (PNI) in patients with resectable non-small cell lung cancer (NSCLC). This retrospective study included 327 consecutive patients with resectable NSCLC with a follow.-up period. >5. years. Initially, the HS-mGPS was directly compared with the GPS and mGPS in terms of their ability to predict survival in patients with resectable NSCLC. Second, inflammation.-based scores, including the HS-mGPS, NLR, PLR, PI, and PNI, were analyzed preoperatively using multivariate Cox analysis. Clinical characteristics reflecting cancer progression were also analyzed. Elevated GPS (P < 0.001), mGPS (P < 0.001), and HS-mGPS (P < 0.001) levels were associated with reduced overall survival. The HS-mGPS (P < 0.001) was superior to the GPS and mGPS (P = 0.884) as a prognostic marker of postoperative outcomes. On multivariate Cox analysis, age (P = 0.026), p-T status (P < 0.001), p-N status (P < 0.001), lymphatic vessel invasion (P = 0.008), and the HS-mGPS (P = 0.016) were independent prognostic factors for survival. These results suggest that the HS-mGPS might have a greater prognostic impact than the GPS, mGPS, NLR, PLR, PI, or PNI in patients with resectable NSCLC.

Abstract A023: The clinical utility of the modified Glasgow Prognostic Score in patients undergoing potentially curative colorectal cancer resection

Abstract The aim of the present study was to examine the clinical utility of assessment of the systemic inflammatory response, using the modified Glasgow Prognostic Score (mGPS), in combination with TNM stage in 1000 consecutive patients undergoing potentially curative colorectal cancer resection in a single institution. An mGPS of 0 (CRP&amp;lt;10mg/L), 1 (CRP&amp;gt;10mg/L/ albumin&amp;lt;35g/L) and 2 (CRP&amp;gt;10mg/L/ albumin&amp;lt;35g/L) was observed in 63%, 21% and 16% of patients respectively. The mGPS was associated with reduced cancer-specific survival (P&amp;lt;0.01), independent of TNM stage; the combination of TNM stage and mGPS stratified five-year survival from 97% (TNM I, mGPS=0) to 32% (TNM III, mGPS=2) (P&amp;lt;0.001). Furthermore, in patients undergoing elective resection of TNM III colon cancer, mGPS stratified survival of patients who received adjuvant chemotherapy from 91% (mGPS=0) to 56% (mGPS=2) (P=0.001). Indeed, the mGPS is routinely available and, in combination with TNM-based staging, provides additional prognostic information following potentially curative colorectal cancer resection. Citation Format: James H. Park, Campbell SD Roxburgh, Paul G. Horgan, Donald C. McMillan. The clinical utility of the modified Glasgow Prognostic Score in patients undergoing potentially curative colorectal cancer resection. [abstract]. In: Proceedings of the CRI-CIMT-EATI-AACR Inaugural International Cancer Immunotherapy Conference: Translating Science into Survival; September 16-19, 2015; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(1 Suppl):Abstract nr A023.

Value of Glasgow prognostic score in patients with adenocarcinoma of esophagogastric junction

To evaluate the prognosis and predictive values of preoperative Glasgow prognostic score (GPS) for adenocarcinoma of esophagogastric junction(AEG) patients. A retrospective study of 322 AEG patients who received operation between January 2007 and March 2010 in Henan Provincial People's Hospital was performed. Clinical data, pathological characteristics, laboratory parameters and survival data were collected. The GPS was calculated based on C-reactive protein(CRP) and serum albumin(ALB) levels. Univariate and multivariate analysis were used to evaluate the prognostic value of GPS. Among 322 patients, 0, 1, 2 of GPS were 192, 104 and 26 patients respectively. The median follow-up was 37 (4-73) months. In Kaplan-Meier analysis, median diseases-free survival (DFS) of GPS 0, 1, 2 was 47.0 (95% CI: 31.6-62.4), 15.0 (95% CI: 11.8-8.2) and 4.7 (95% CI: 3.8-5.6) months (P<0.01), and median overall survival (OS) was out of reach, 20.6 (95% CI: 15.8-25.4) and 7.0 (95% CI: 5.8-8.2) months (P<0.01). Univariate and multivariate analysis revealed that GPS was an independent predictor of DFS (P<0.01) and OS (P<0.01) of AEG. GPS is an effective predictor of survival in AEG.

Prognostic Role of Glasgow Prognostic Score in Patients With Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

Conflicting results about the prognostic value of Glasgow Prognostic Score (GPS) in hepatocellular carcinoma (HCC) patients have been reported. We searched the available articles and performed the meta-analysis to clarify the predictive value of GPS in HCC patients’ outcome.A systematic literature search was conducted using PubMed (Medline), Embase, Cochrane Library, Web of Science, ChinaInfo, and Chinese National Knowledge Infrastructure for all years up to September 2015. Studies analyzing the relationship of GPS and survival outcome were identified. Hazard ratio (HR) with 95% confidence interval (CI) was calculated to assess the risk.A total of 10 studies were finally enrolled in the meta-analysis. The pooled estimates demonstrated a significant relationship between elevated GPS and inferior overall survival in patients with HCC (HR = 2.156, 95% CI: 1.696–2.740, P < 0.001). Patients with increased GPS had a tendency toward shorter progression-free survival (HR = 1.755, 95% CI: 0.943–3.265, P = 0.076). And elevated GPS was found to be significantly associated with advanced Child–Pugh class (odds ratio = 25.979, 95% CI: 6.159–109.573, P < 0.001). The publication bias analysis revealed that there was publication bias in the meta-analysis.Glasgow Prognostic Score may be an independent prognostic factor in patients with HCC. More well-designed studies with adequate follow-up duration are warranted.

Prediction of long‐term survival by using the Glasgow Prognostic Score in patients with hepatocellular carcinoma after liver transplantation

This study aimed to validate the prognostic value of the Glasgow Prognostic Score (GPS) in patients who underwent living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC). Data were retrospectively collected for HCC patients who underwent LDLT. Univariate and multivariate analyses were performed to identify variables associated with overall and recurrence-free survival. Patients were separated into two groups based on the GPS. The predictive ability of the GPS was compared with other variable scores (modified GPS and hepatic GPS) to identify the most accurate test for this population. Univariate analysis identified a GPS of 1 or 2 (P = 0.018), multiple tumors (P = 0.032) and HCC beyond the Milan criteria (P = 0.015) as factors significantly associated with poor overall survival. Hepatitis B negative status (P = 0.034), a GPS of 1 or 2 (P = 0.030), α-fetoprotein of 20.0ng/mL or more (P = 0.042) and HCC beyond the Milan criteria (P = 0.002) were identified as factors significantly associated with poor recurrence-free survival. Multivariate analysis indicated that HCC beyond the Milan criteria and a GPS of 1 or 2 were independent risk factors for long-term outcomes. Among the scoring systems evaluated in this study, the GPS was the best predictive system in our population. Moreover, a new scoring system that combined the GPS and the Milan criteria showed the highest prognostic values. Novel prediction scores combining the GPS and the Milan criteria provide a precise, objective, and quick approach for selecting appropriate HCC patients for LDLT.

Prognostic Value of the Modified Glasgow Prognostic Score in Patients Undergoing Radical Surgery for Hepatocellular Carcinoma.

There is increasing and consistent evidence concerning the association of systemic inflammation and poor outcome in patients with hepatocellular carcinoma (HCC). The aim of this study was to identify a superior inflammation-based prognostic scoring system for patients with HCC undergoing hepatectomy.We analyzed two independent cohorts of a total of 723 patients with HCC who underwent radical surgery between 2010 and 2012. The prognostic value of the inflammation scores, including the Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio, platelet lymphocyte ratio, prognostic index, and prognostic nutritional index, as well as the Barcelona Clinic Liver Cancer and Cancer of the Liver Italian Program staging systems was analyzed in a test cohort of 367 patients and validated in a validation cohort of 356 patients.A high score with the mGPS was associated with large tumor size, vascular invasion, and advanced clinical stage. Multivariate analysis showed that the mGPS was independently associated with overall survival and disease-free survival, and had a higher area under the curve value in comparison with other inflammation-based scores.The results of this study demonstrated that the mGPS is an independent marker of poor prognosis in patients with resectable HCC and is superior to other inflammation-based scores.

Clinical and prognostic significance of pathological and inflammatory markers in the surgical treatment of locally advanced colorectal cancer.

BackgroundLocally advanced colorectal cancer (CRC) may vary in its clinical and pathological appearance. It is now accepted that progression of disease in patients with locally advanced CRC is determined not only by local tumor characteristics but also by the immune system and inflammatory response in the body.MethodsWe investigated patients with confirmed CRC who were treated in the surgical clinic at the University Hospital Alexandrovska over a 10-year period and retrospectively evaluated the histological features of the preoperative biopsies and operative specimens removed during radical multivisceral resections. We also collected prospective data for serum C-reactive protein levels and Jass-Klintrup score, Petersen Index score, and Glasgow Prognostic Score in patients with locally advanced CRC.ResultsOf 1,105 patients with CRC, 327 (29.6%) were diagnosed with locally advanced disease. In total, 108 combined multivisceral resections (79 for primary tumors and 29 for recurrent tumors) were performed. Overall survival was 34 months for pR0 cases and 12 months for pR1 cases (P<0.05). Our data confirmed that C-reactive protein is a prognostic marker of overall survival. Data for 48 patients with histologically confirmed locally advanced tumors showed significantly increased survival with a higher Jass-Klintrup score (P=0.037). In patients with node-negative disease, 5-year survival was 49%. However, where there were high-risk pathological characteristics according to the Petersen Index, survival was similar to that for node-positive disease (P=0.702). Our data also showed a significant difference in survival between groups divided according to whether they had a modified Glasgow Prognostic Score of 1 or 2 (P=0.031).ConclusionIn order to maintain a reasonable balance between an aggressive approach and so-called meaningless “surgical exorbitance”, we should focus on certain histopathological and inflammatory markers that can be identified as additional factors for planning the type and volume of surgical treatment.

Clinical utility of the modified Glasgow prognostic score in patients with advanced head and neck cancer.

The purpose of this study was to evaluate the prognostic potential of the modified Glasgow prognostic score (mGPS), known to reflect the degree of tumor-associated inflammation and cancer cachexia, in patients with advanced head and neck cancer. Patients with advanced head and neck cancer treated at the University of Tsukuba Hospital between January 2002 and December 2011 were retrospectively evaluated. They were categorized by their mGPS. A total of 210 patients were enrolled in this study. Patients with an mGPS of 0 had better overall survival and disease-free survival than did those with an mGPS of 1 or 2. Multivariate analysis revealed that the mGPS was a significant risk factor for overall survival and disease-free survival. Our results suggest that the mGPS is useful for predicting outcome in patients with advanced head and neck cancer and should be included in their routine clinical assessment.

Clinical Utility of the Glasgow Prognostic Score in Patients with Advanced Head and Neck Cancer

Objectives: The modified Glasgow prognostic score (mGPS) is known to reflect the degree of tumor-associated inflammation and cancer cachexia and is associated with survival in various malignancies. The prognostic value of mGPS in head and neck cancers remains unclear. The purpose of this study was to evaluate the prognostic potential of the mGPS in patients with advanced head and neck cancer. Methods: Patients with advanced head and neck cancer treated at the University of Tsukuba Hospital between January 2002 and December 2011 were retrospectively evaluated. They were divided according to their mGPS. The mGPS was calculated based on the admission data as follows: patients with an elevated level of C-reactive protein (&gt;1.0 mg/dL) and hypoabuminemia (&lt;3.5 g/dL) were allocated a score of 2, patients with elevated C-reactive protein serum levels without hypoalbuminaemia were allocated a score of 1, and patients with neither of these abnormalities were allocated a score of 0. The utility of the mGPS as a prognostic indicator was evaluated. Results: A total of 210 patients enrolled. Patients with an mGPS of 0 had better overall survival and disease-free survival than did those with an mGPS of 1 or 2. Multivariate analysis revealed that the mGPS was a significant risk factor for overall survival and disease-free survival. Conclusions: The results that patients with a raised mGPS had a significantly higher risk of death suggest that the mGPS is useful for predicting outcome in patients with advanced head and neck cancer and should be included in their routine clinical assessment.