Evaluation of an inflammation‐based prognostic score in patients with metastatic renal cancer

Murri, A M Al; Bartlett, J. M. S.; Canney, Peter; Doughty, Julie; Wilson, Chris; McMillan, Donald C.

doi:10.1002/cncr.22400

Cited by 240 publications

(174 citation statements)

References 67 publications

(27 reference statements)

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“…These studies ( Table 2) have demonstrated that the prognostic value of the GPS is independent of tumour stage (all studies) and conventional scoring systems (44) , superior to performance status (39,42) and superior to other markers of the systemic inflammatory response such as leucocyte or lymphocyte counts (39,40,42,44,45) . Having established a scoring system (the GPS) based on the systemic inflammation-driven loss of weight, lean tissue and performance status, it was of interest to examine its relationship with the general biochemical disturbance of patients with advanced cancer (46) .…”

Section: Development Of a Systemic-inflammation-based Scorementioning

confidence: 98%

An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer

2008

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Progressive involuntary weight loss, in particular the loss of lean tissue, is common in patients with advanced cancer and has long been recognised to result in a deterioration in performance status and quality of life, increased morbidity and mortality. The aetiology of such weight loss or cachexia is complex and involves both tumour and host responses. Thus, identification of patients who are or are likely to become cachectic has been problematic. In addition to a reduction in appetite and increased satiety leading to poor dietary intake, there is now increasing clinical evidence that the activation of a chronic ongoing systemic inflammatory response is one of the earliest and most important contributory factors to cachexia. Such findings help to explain the failure of simple nutritional programmes to reverse weight loss adequately in patients with cancer. In the present paper the development of an inflammationbased score is described, which is derived from the acute-phase proteins C-reactive protein and albumin and is termed the Glasgow prognostic score (GPS). Its value as a predictor of survival, independent of tumour stage, performance status and treatment (active or palliative), has been shown in a variety of advanced common solid tumours. The nature of the relationship between the GPS, appetite, body composition, performance status and quality of life of the patient with advanced cancer will be described. Recently, it has become evident that the systemic inflammatory response is also present in a smaller proportion of patients with primary operable cancer and is also predictive of disease progression and poor survival. The role of GPS in clinical decision making will be discussed.

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Section: Development Of a Systemic-inflammation-based Scorementioning

confidence: 98%

An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer

2008

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“…60 Although the response rate itself is not considered a good surrogate for OS in metastatic RCC, 61 CRP is not only a predictive marker for response, but also a significant prognostic indicator for survival in patients with metastatic RCC. [51][52][53]55,62 In a large Japanese multicenter cohort of 1463 metastatic RCC patients, 62 CRP had significant prognostic impact on OS, as well as time from initial visit to metastasis, Eastern Cooperative Oncology Group Performance Status, serum lactate dehydrogenase and Ca level, all of which were included in the MSKCC criteria. 63 The 1-year OS rate of 598 patients with elevated CRP levels (>3 mg/L) was 55%, compared with 84.7% of 266 patients without those.…”

Section: Prognostic Value Of Crp In Renal Cell Carcinomamentioning

confidence: 99%

“…Two prognostic algorithms have been developed for application to metastatic RCC: the MRCCPS 54 and the GPS. 55 In the GPS, both elevated CRP levels (>10 mg/L) and hypoalbuminemia (<35 g/L) were given a score of 2, whereas either elevated CRP or hypoalbuminemia were given a score of 1. Albumin is a negative acute-phase reactant whose levels decreased under systemic inflammation.…”

Section: Incorporation Of Crp Into Prognostic Algorithms In Rcc Patientsmentioning

confidence: 99%

Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

Saito

Kihara

2012

Int J of Urology

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Abbreviations & AcronymsAbstract: Based on increasing evidence of the association between cancer-related inflammation and the progression of cancer, the external symptoms of systemic inflammatory response has been shown to be an indicator for the prognosis of many malignancies, including urological cancers. C-reactive protein, a representative acute-phase reactant, is a significant and sensitive inflammatory marker that can be objectively measured using reliable assays in clinical practice worldwide. C-reactive protein has been shown to be significant in the prediction of outcomes of urological cancers. The elevation of C-reactive protein levels, which indicate the presence of cancer-associated systemic inflammatory response, is linked to poorer survival in patients with urological cancers, including renal cell carcinoma, upper urinary tract and bladder cancers, and prostate cancer. With this strong prognostic ability, C-reactive protein can be incorporated into prognostic models and will make them simpler and improve their predictive accuracy. Furthermore, the longitudinal change of C-reactive protein level, C-reactive protein kinetics, provides additional information on patient survival outcomes. As such, C-reactive protein can be used to monitor treatment efficacy and disease course using serial measurements. In testicular cancer, C-reactive protein is associated with a risk of late complications, such as cardiovascular disease, and with the development of second non-germ-cell cancer. Taken together, these findings show that C-reactive protein can act as an important biomarker for urological cancers. This review discusses the importance of C-reactive protein as a prognostic biomarker in urological cancers on the basis of the currently available evidence.

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“…It is now accepted that the host systemic inflammatory response can be assessed by examining the changes in the circulating concentrations of acute-phase proteins, such as elevated concentration of C-reactive protein and low concentrations of albumin (Gabay and Kushner, 1999;McMillan et al, 2001). It is of interest that either singly or combined these factors have been shown to be stage-and performance status-independent prognostic factors in patients with a variety of inoperable cancers (Forrest et al, 2003(Forrest et al, , 2004Al Murri et al, 2006;Crumley et al, 2006;Glen et al, 2006;Ramsey et al, 2007). Similarly, singly these factors have been shown to be tumour stage-independent prognostic factors, prior to surgery, in patients with a variety of primary operable cancers including colorectal cancer (Heys et al, 1998;Longo et al, 1998;Nozoe et al, 1998;Longo et al, 2000;Nielsen et al, 2000;McMillan et al, 2003).…”

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Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer

et al. 2007

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There is increasing evidence that the presence of a systemic inflammatory response plays an important role in predicting survival in patients with colorectal cancer. However, it is not clear what components of the systemic inflammatory response best predict survival. The aim of the present study was to compare the prognostic value of an inflammation-based prognostic score (modified Glasgow Prognostic Score (Mgps) 0 ¼ C-reactive protein o10 mg l À1 , 1 ¼ C-reactive protein 410 mg l À1 , and 2 ¼ C-reactive protein 410 mg l À1 and albumino35 g l À1 ) with that of components of the white cell count (neutrophils, lymphocytes, monocytes and platelets using standard thresholds) in patients with colorectal cancer. Two patient groups were studied: 149 patients who underwent potentially curative resection for colorectal cancer and 84 patients who had synchronous unresectable liver metastases. In those patients who underwent potentially curative resection the minimum follow-up was 36 months and 20 patients died of their cancer. On multivariate survival analysis only TNM stage (HR 3.75, 95% CI 1.54 -9.17, P ¼ 0.004), monocyte count (HR 3.79, 95% CI 1.29 -11.12, P ¼ 0.015) and mGPS (HR 2.21, 95% CI 1.11 -4.41, P ¼ 0.024) were independently associated with cancer-specific survival. In patients with synchronous unresectable liver metastases the minimum follow-up was 6 months and 71 patients died of their cancer. On multivariate survival analysis only single liver metastasis 45 cm (HR 1.78, 95% CI 0.99 -3.21, P ¼ 0.054), extrahepatic disease (HR 2.09, 95% CI 1.05 -4.17, P ¼ 0.036), chemotherapy treatment (HR 2.40, 95% CI 1.82 -3.17, Po0.001) and mGPS (HR 1.44, 95% CI 1.01 -2.04, P ¼ 0.043) were independently associated with cancer-specific survival. In summary, markers of the systemic inflammatory response are associated with poor outcome in patients with either primary operable or synchronous unresectable colorectal cancer. An acute-phase protein-based prognostic score, the mGPS, appears to be a superior predictor of survival compared with the cellular components of the systemic inflammatory response.

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Evaluation of an inflammation‐based prognostic score in patients with metastatic renal cancer

Cited by 240 publications

References 67 publications

An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer

An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer

Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer

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