Comparison of the prognostic value of various preoperative inflammation-based factors in patients with stage III gastric cancer

Abstract

The aim of present study was to examine whether the C-reactive protein (CRP)-based systemic inflammatory response such as the Glasgow Prognostic Score (GPS; a combination of CRP and albumin) offers prognostic value that is superior to the circulating white cellular components as neutrophil/lymphocyte ratio (NLR) or platelet/lymphocyte ratio (PLR) in patients undergoing resection for stage III gastric cancer. The medical records of 324 patients with stage III gastric adenocarcinoma were reviewed. Potential prognosis factors were evaluated with the Kaplan-Meier methodology and multivariable Cox hazards model. An increase of GPS was associated with an increase weight loss, higher NLR, higher PLR, and larger tumor size. On multivariate analysis, only the GPS, tumor-nodes-metastasis staging, and adjuvant chemotherapy were associated independently with disease-free and overall survival. However, the NLR and PLR were not. In subgroup analysis, patients with a GPS of 2 had a significantly poorer median survival (13.70 months) when compared with patients with a GPS of 1 (27.4 months) or 0 (median survival had not been reached) in patients who had received adjuvant chemotherapy. Our study demonstrated that elevated preoperative GPS is superior to circulating white cellular components and was associated with reduced overall and disease-free survival for patients with stage III gastric cancer.

Glasgow prognostic score is superior to other inflammation-based scores in predicting survival of diffuse large B-cell lymphoma

“…Whereas, studies from Deshen et al suggested that PLR was not an independent prognostic factor in gastric cancer patients, which we also confirmed in the present study [19]. However, it might be worthy to investigate larger-scale study to validate whether PLR was an independent index.…”

“…Previous studies have proved that NLR is an independent predictor in gastric tumor [18]. However, it is still controversial, Deshen et al demonstrated that NLR was not correlated with OS and EFS in post-operated gastric cancer patients [19]. In our retrospective study, we also demonstrated that NLR was not an independent predictor in DLBCLs.…”

Prognostic Role of C-reactive Protein in Gastric Cancer: A Meta-analysis

“…Interestingly, some recent studies suggested that Glasgow prognostic score (GPS) was an independent prognostic marker for gastric cancer patients (Hwang et al, 2011;Wang et al, 2012;Jeong et al, 2012). GPS is a combination of serum CRP and albumin concentrations (Forrest et al, 2003), which appears to reflect the systemic inflammatory response as well as nutritional status (Kao et al, 2010;Proctor et al, 2011).…”

Glasgow Prognostic Score predicts prognosis of intrahepatic cholangiocarcinoma

“…Although GPS has frequently been associated with the prognosis of solid tumours, such as lung (22,23), liver (27,28), kidney (26), ovarian (24), colorectal (25), gastric (41,42) and pancreatic cancer (43), the association has yet to be fully elucidated. One component of the GPS score, CRP, is an acute phase protein synthesized by hepatocytes in response to inflammation, infection, tissue damage and cancer, reflecting systemic inflammation (44).…”