The modified glasgow prognostic score is an independent prognostic indicator in neoadjuvantly treated adenocarcinoma of the esophagogastric junction

Abstract

The modified Glasgow Prognostic Score (mGPS) combines the indicators of decreased plasma albumin and elevated CRP. In a number of malignancies, elevated mGPS is associated with poor survival. Aim of this study was to investigate the prognostic role of mGPS in patients with neoadjuvantly treated adenocarcinomas of the esophagogastric junction 256 patients from a prospective database undergoing surgical resection after neoadjuvant treatment between 2003 and 2014 were evaluated. mGPS was scored as 0, 1, or 2 based on CRP (>1.0 mg/dl) and albumin (<35 g/L) from blood samples taken prior (preNT-mGPS) and after (postNT-mGPS) neoadjuvant therapy. Scores were correlated with clinicopathological patients’ characteristics. From 155 Patients, sufficient data was available. Median follow-up was 63.8 months (33.3–89.5 months). In univariate analysis, Cox proportional hazard model shows significant shorter patients OS (p = 0.04) and DFS (p = 0.02) for increased postNT-mGPS, preNT-hypoalbuminemia (OS: p = 0.003; DFS: p = 0.002) and post-NT-CRP (OS: p = 0.03; DFS: p = 0.04). Elevated postNT-mGPS and preNT-hypoalbuminemia remained significant prognostic factors in multivariate analysis for OS (p = 0.02; p = 0.005,) and DFS (p = 0.02, p = 0.004) with tumor differentiation and tumor staging as significant covariates. PostNT-mGPS and preNT-hypoalbuminemia are independent prognostic indicators in patients with neoadjuvantly treated adenocarcinomas of the esophagogastric junction and significantly associated with diminished OS and DFS.

C‐reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer

“…Recently, several common inflammation‐based prognostic scores, including the NLR, PLR, GPS, and CONUT score have been reported to have prognostic value in patients with various types of cancers . These biomarkers can be evaluated easily by sampling a small amount of peripheral blood.…”

“…There is increasing data that malnutrition, skeletal muscle loss, and a systemic inflammatory response are associated with poor outcomes in patients suffering from various types of cancers . We previously reported that skeletal muscle loss was strongly associated with a poor long‐term prognosis in patients who underwent surgical treatment of AEG and UGC .…”

“…We previously reported that skeletal muscle loss was strongly associated with a poor long‐term prognosis in patients who underwent surgical treatment of AEG and UGC . Also, several common inflammation‐based prognostic scores, including the neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), Glasgow Prognostic Score (GPS), and controlling nutritional status (CONUT) score have been reported to have prognostic value in patients with many types of malignant, solid tumors . The C‐reactive protein (CRP)/albumin (Alb) ratio has also been reported as a novel inflammation‐based prognostic marker in multiple types of tumors, including hepatocellular carcinoma, colorectal cancer, esophageal cancer, renal cancer, pancreatic cancer, and gastric cancer …”

“…There is increasing data that malnutrition, skeletal muscle loss, and a systemic inflammatory response are associated with poor outcomes in patients suffering from various types of cancers. [7][8][9][10][11][12][13] We previously reported that skeletal muscle loss was strongly associated with a poor long-term prognosis in patients who underwent surgical treatment of AEG and UGC. 14 Also, several common inflammation-based prognostic scores, including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Glasgow Prognostic Score (GPS), and controlling nutritional status (CONUT) score have been reported to have prognostic value in patients with many types of malignant, solid tumors.…”

“…14 Also, several common inflammation-based prognostic scores, including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Glasgow Prognostic Score (GPS), and controlling nutritional status (CONUT) score have been reported to have prognostic value in patients with many types of malignant, solid tumors. 7,[15][16][17][18][19][20][21][22][23][24][25] The C-reactive protein (CRP)/albumin (Alb) ratio has also been reported as a novel inflammation-based prognostic marker in multiple types of tumors, including hepatocellular carcinoma, colorectal cancer, esophageal cancer, renal cancer, pancreatic cancer, and gastric cancer. 21,[26][27][28][29][30][31] In the present study, we investigated the prognostic value of the CRP/Alb ratio in patients who underwent surgery for AEG and UGC.…”