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...

This study assessed the antioxidant potencies of several widespread dietary flavonoids across a range of concentrations and compared with vitamin C as a positive control. The antioxidant effects of pretreatment with flavonoids and vitamin C, at standardized concentrations (7.6, 23.2, 93, and 279.4 mol/L), on oxygen radical-generated DNA damage from hydrogen peroxide (100 mol/L) in human lymphocytes were examined by using the single-cell gel electrophoresis assay (comet assay). Pretreatment with all flavonoids and vitamin C produced dose-dependent reductions in oxidative DNA damage. At a concentration of 279 mol/L, they were ranked in decreasing order of potency as follows: luteolin (9% of damage from unopposed hydrogen peroxide), myricetin (10%), quercetin (22%), kaempferol (32%), quercitrin (quercetin-3-L-rhamnoside) (45%), apigenin (59%), quercetin-3-glucoside (62%), rutin (quercetin-3-␤-D-rutinoside) (82%), and vitamin C (78%). The protective effect of vitamin C against DNA damage at this concentration was significantly less than that of all the flavonoids except apigenin, quercetin-3-glucoside, and rutin. The ranking was similar with estimated ED 50 (concentration to produce 50% protection) values. The protective effect of quercetin and vitamin C at a concentration of 23.2 mol/L was found to be additive (quercetin: 71% of maximal DNA damage from unopposed hydrogen peroxide; vitamin C: 83%; both in combination: 62%). These data suggest that the free flavonoids are more protective than the conjugated flavonoids (eg, quercetin compared with its conjugate quercetin-3-glucoside, P < 0.001). Data are also consistent with the hypothesis that antioxidant activity of free flavonoids is related to the number and position of hydroxyl groups.

The value of an inflammation-based prognostic score (Glasgow Prognostic score, GPS) was compared with performance status (ECOG-ps) in a longitudinal study of patients (n ¼ 101) with inoperable non-small-cell lung cancer (NSCLC). At diagnosis, stratified for treatment, only the GPS (HR 2.32, 95% CI 1.52 -3.54, Po0.001) was a significant predictor of survival. In contrast, neither the GPS nor ECOG-ps measured at 3 -6 months follow-up were significant predictors of residual survival. This study confirms the prognostic value of the GPS, at diagnosis, in patients with inoperable NSCLC. However, the role of the GPS and ECOG-ps during follow-up has not been established.

These preliminary results suggest CE-IOUS is an essential tool prior to liver resection for metastases.

The assessment of prognosis in patients with advanced cancer remains problematical. The value of C-reactive protein concentration in this context has not been clearly defined. Patients with a diagnosis of colorectal (n = 182), gastric (n = 87), breast (n = 99), or bronchogenic (n = 404) cancer and who had measurements of C-reactive protein and albumin were identified. Median survival, from the time of sampling, ranged from 478 days in the colorectal cancer patients to 60 days in patients with bronchogenic cancer. On univariate analysis, there was, in each tumor type, a significant relationship between the duration of survival and both log10 C-reactive protein and albumin concentrations (P < or = 0.0002). On multivariate analysis, in each tumor type, log10 C-reactive protein remained a significant independent predictor of survival (P < or = 0.0002). When all four groups of cancer patients were analyzed (n = 772), the hazard ratio for a 10-fold increase in C-reactive protein concentration in cancer-specific survival was 2.21 (95% confidence interval = 1.92-2.56, P < 0.0001) and the corresponding hazard ratio for non-cancer survival was 5.48 (95% confidence interval = 3.55-8.46, P < 0.0001). The results of the present study indicate that in advanced cancer patients the presence of a systemic inflammatory response and the magnitude of that response predict the duration of cancer-specific and non-cancer survival.

The assessment of prognosis in patients with advanced cancer remains problematical. The value of C-reactive protein concentration in this context has not been clearly defined. Patients with a diagnosis of colorectal (n = 182), gastric (n = 87), breast (n = 99), or bronchogenic (n = 404) cancer and who had measurements of C-reactive protein and albumin were identified. Median survival, from the time of sampling, ranged from 478 days in the colorectal cancer patients to 60 days in patients with bronchogenic cancer. On univariate analysis, there was, in each tumor type, a significant relationship between the duration of survival and both log10 C-reactive protein and albumin concentrations (P < or = 0.0002). On multivariate analysis, in each tumor type, log10 C-reactive protein remained a significant independent predictor of survival (P < or = 0.0002). When all four groups of cancer patients were analyzed (n = 772), the hazard ratio for a 10-fold increase in C-reactive protein concentration in cancer-specific survival was 2.21 (95% confidence interval = 1.92-2.56, P < 0.0001) and the corresponding hazard ratio for non-cancer survival was 5.48 (95% confidence interval = 3.55-8.46, P < 0.0001). The results of the present study indicate that in advanced cancer patients the presence of a systemic inflammatory response and the magnitude of that response predict the duration of cancer-specific and non-cancer survival.