A score based on the combination of the systemic inflammatory response and albumin hazards ratio (HR) 1.70, 95% CI 1.23 -2.35, P ¼ 0.001) was comparable in prognostic value to that based on stage and performance status (HR 1.48, 95% CI 1.12 -1.95, P ¼ 0.006) in patients with inoperable non-small-cell lung cancer. The former is simple to measure and well standardised.

The results of the present study indicate that the GPS, before surgery, predicts overall and cancer-specific survival after resection of colon and rectal cancer.

The value of an inflammation-based prognostic score (GPS) was compared with performance status (ECOG) in patients (n ¼ 109) receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. On multivariate analysis with ECOG, white cell count and the GPS entered as covariates, only the GPS was a significant independent predictor of survival (HR 1.88, 95% CI 1.25 -2.84, P ¼ 0.002). Non-small-cell lung cancer (NSCLC) is the most common cause of cancer death in North America and Western Europe. Most patients present with advanced inoperable disease; the prognosis of these patients is extremely poor. In selected patients, platinum-based regimens have been shown to have a beneficial but modest impact on survival (Klastersky and Paesmans, 2001). Conventionally, the selection of patients for chemotherapy has been based on clinicopathological criteria, including age, stage and performance status (Numico et al, 2001).There is increasing evidence that the presence of a systemic inflammatory response, as evidenced by elevated circulating concentrations of C-reactive protein concentrations, is associated with early recurrence and poor survival, independent of stage, in a variety of common solid tumours (Ikeda et al, 2003;McMillan et al, 2003). In advanced disease, an elevated C-reactive protein has also been shown to associated with poor survival (O'Gorman et al, 2000;Mahmoud and Rivera, 2002).Furthermore, in an unselected cohort of patients with inoperable NSCLC, the Glasgow Prognostic Score (GPS), a cumulative prognostic score based on C-reactive protein and albumin, had similar prognostic value to that of stage and performance status (Forrest et al, 2003). The question of whether the GPS would be useful in the selection of appropriate treatment for patients with inoperable NSCLC remains to be determined.The aim of the present study was to assess the value of the GPS in patients receiving chemotherapy for inoperable NSCLC. MATERIALS AND METHODS Study designPatients presenting with inoperable NSCLC (stages III and IV) to a single multidisciplinary oncology clinic in Glasgow Royal Infirmary between March 2000 and June 2003 were studied prospectively. All patients had cytologically or histologically confirmed disease and were staged on the basis of clinical findings, chest X-ray and, where appropriate, bronchoscopy, liver ultrasound, isotope bone scan and computerised tomography of the thorax, according to the American Thoracic Society TNM classification (Mountain, 1991).Clinical stage, tumour type and performance status (Eastern Cooperative Oncology Group, ECOG) were recorded at the time of diagnosis. A blood sample was also obtained for the measurement of white cell count, albumin and C-reactive protein concentrations. Patients received between one and six cycles of platinum-based chemotherapy.The study was approved by the Research Ethics Committee of Glasgow Royal Infirmary. MethodsBlood parameters: Routine laboratory measurements of albumin and C-reactive protein concentration were carried out. The coeffic...

In patients who have undergone potentially curative resection for colorectal cancer, the presence of a systemic inflammatory response predicts a poor outcome.

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