Clinical Implication of Inflammation-Based Prognostic Score in Pancreatic Cancer

Yamada, Suguru; Fujii, Tsutomu; Yabusaki, Norimitsu; Murotani, Kenta; Iwata, Nakao; Kanda, Mitsuro; Tanaka, Chie; Nakayama, Goro; Sugimoto, Hiroyuki; Koike, Masahiko; Fujiwara, Michitaka; Kodera, Yasuhiro

doi:10.1097/md.0000000000003582

Cited by 95 publications

(78 citation statements)

References 33 publications

(29 reference statements)

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“…A number of studies have also found similar results for the prognostic role CAR or GPS in various types of cancers. [7][8][9][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] This highlighted the general prognostic role of these two inflammation-based scores in malignancies.…”

Section: Discussionmentioning

confidence: 99%

<p>Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma</p>

Chen

Liu

Feng

et al. 2020

CMAR

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The prognostic significance of inflammation-based biomarkers for neuroblastoma (NB) has not been investigated before. The aim of this study was to evaluate the prognostic value of pre-treatment inflammation biomarkers in children patients with NB. Patients and Methods: Patients diagnosed with NB from 2008 to 2016 in our institution were enrolled in this study. The clinical data and survival outcomes were retrospectively reviewed. Inflammation biomarkers or scores including C-reactive protein (CRP), albumin (ALB), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), high-sensitivity modified Glasgow Prognostic Score (Hs-mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and system inflammation index (SII) were tested in this study. Univariate and multivariate survival analyses were performed to assess the prognostic value of these inflammation indicators for overall survival (OS) of children with NB. Kaplan-Meier survival curves were also conducted. Results: A total of 70 children diagnosed with neuroblastoma were enrolled in this study. NLR, PLR, LMR and SII were found to be not predictive of OS for NB patients. However, CRP, ALB, GPS and CAR were significantly associated with OS of NB patients. Multivariate analysis adjusting for age, sex, histology, tumor size, tumor stage and metastasis revealed that ALB, CAR, GPS and Hs-mGPS were significantly associated with OS of NB patients. Receiver operating characteristic (ROC) curves and Akaike Information Criterion (AIC) analyses revealed that Hs-mGPS is superior to other inflammation biomarkers in predicting OS of NB patients. Subgroup survival analysis for immature NB patients revealed similar results. Conclusion: Hs-mGPS is an effective prognostic factor for OS of patients with NB and is promising to be used as a factor for risk stratification and an indicator for more aggressive therapy.

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Section: Discussionmentioning

confidence: 99%

<p>Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma</p>

Chen

Liu

Feng

et al. 2020

CMAR

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“…GPS was derived from the acute-phase proteins C-reactive protein and albumin, which were more sensitive and reliable markers that reflect the systemic inflammatory response in cancer patients. Until now, GPS has been shown to be a favorable predictor of survival in patients with various cancers [30,31,32,33]. Recently, more researchers are focusing on investigating the modified GPS, named mGPS, which also is a combination of C-reactive protein and albumin [34].…”

Section: Discussionmentioning

confidence: 99%

A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma

Chen

Liu

et al. 2016

IJMS

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Recent studies have indicated that inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS), modified GPS (mGPS) and C-reactive protein/Albumin (CRP/Alb) ratio, platelet–lymphocyte ratio (PLR), and neutrophil–lymphocyte ratio (NLR), have been reported to have prognostic value in patients with many types of cancer, including nasopharyngeal carcinoma (NPC). In this study, we proposed a novel inflammation-based stage, named I stage, for patients with NPC. A retrospective study of 409 newly-diagnosed cases of NPC was conducted. The prognostic factors (GPS, mGPS, CRP/Alb ratios, PLR, and NLR) were evaluated using univariate and multivariate analyses. Then, according to the results of the multivariate analyses, we proposed a I stage combination of independent risk factors (CRP/Alb ratio and PLR). The I stage was calculated as follows: patients with high levels of CRP/Alb ratio (>0.03) and PLR (>146.2) were defined as I2; patients with one or no abnormal values were defined as I1 or I0, respectively. The relationships between the I stage and clinicopathological variables and overall survival (OS) were evaluated. In addition, the discriminatory ability of the I stage with other inflammation-based prognostic scores was assessed using the AUCs (areas under the curves) analyzed by receiver operating characteristics (ROC) curves. The p value of <0.05 was considered to be significant. A total of 409 patients with NPC were enrolled in this study. Multivariate analyses revealed that only the CRP/Alb ratio (Hazard ratio (HR) = 2.093; 95% Confidence interval (CI): 1.222–3.587; p = 0.007) and PLR (HR: 2.003; 95% CI: 1.177–3.410; p = 0.010) were independent prognostic factors in patients with NPC. The five-year overall survival rates for patients with I0, I1, and I2 were 92.1% ± 2.9%, 83.3% ± 2.6%, and 63.1% ± 4.6%, respectively (p < 0.001). The I stage had a higher area under the curve value (0.670) compared with other systemic inflammation-based prognostic scores (p < 0.001). The I stage is a novel and useful predictive factor for OS in patients with NPC.

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“…There are many reports concerning the relation between each inflammation-based marker and the prognosis of PDAC, but there are few reports comparing the utility of several inflammation-based markers. Yamada et al (21) conducted a retrospective study to clarify which score could best reflect survival in resected pancreatic cancer patients and found that GPS was superior to the other markers. Additionally, a systematic review summarized past reports Table IV.…”

Section: Univariate Multivariate ------------------------------------mentioning

confidence: 99%

Evaluation of inflammation‑based markers for predicting the prognosis of unresectable pancreatic ductal adenocarcinoma treated with chemotherapy

et al. 2018

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Predicting the prognosis of unresectable pancreatic ductal adenocarcinoma (PDAC) is useful in determining the appropriate management strategy. The present study aimed to investigate the association between PDAC prognosis and inflammation-based markers, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, prognostic nutritional index, modified Glasgow prognostic score (mGPS) and controlling nutritional status score. A total of 72 patients with unresectable PDAC who received chemotherapy were included. Inflammation-based markers were measured prior to treatment. The median progression-free survival (PFS) and overall survival (OS) were 117 days (range, 10-781 days) and 244 days (range 43-781 days), respectively. The cut-off value of continuous variables that predicted the median OS (244 days) was calcualted. Univariate analysis of PFS showed that disease stage, first-line chemotherapy regimen, carcinoembryonic antigen (CEA), NLR, platelet-to-lymphocyte ratio (PLR), mGPS and controlling nutritional status (CONUT) scores were associated with PFS. Among them, stage, first-line chemotherapy regimen, CEA, NLR and mGPS were independent prognostic factors for PFS in multivariate analysis. Univariate analysis of OS showed that stage, first-line chemotherapy regimen, CA19-9, NLR, PLR, prognostic nutritional index (PNI), mGPS and CONUT score were associated wtih OS. Among them, first-line chemotherapy and mGPS were independent prognostic factors for OS according to multivariate analysis. Univariate and multivariate analyses revealed that a NLR ≥4.0 and mGPS 2 were independent prognostic factors for PFS. For OS, mGPS 2 was an independent prognostic factor. In conclusion, mGPS was the most useful marker in predicting the prognosis of patients with unresectable PDAC who received chemotherapy.

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Clinical Implication of Inflammation-Based Prognostic Score in Pancreatic Cancer

Abstract: Supplemental Digital Content is available in the text

Cited by 95 publications

References 33 publications

<p>Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma</p>

<p>Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma</p>

A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma

Evaluation of inflammation‑based markers for predicting the prognosis of unresectable pancreatic ductal adenocarcinoma treated with chemotherapy

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