Glasgow Prognostic Score is superior to ECOG PS as a prognostic factor in patients with gastric cancer with peritoneal seeding

Abstract

Abstract. The Glasgow Prognostic Score (GPS) has been shown to be associated with survival rates in patients with advanced cancer. The present study aimed to compare the GPS with the Eastern Cooperative Oncology Group Performance Status (ECOG PS) in patients with gastric cancer with peritoneal seeding. For the investigation, a total of 384 gastric patients with peritoneal metastasis were retrospectively analyzed. Patients with elevated C-reactive protein (CRP; >10 mg/l) and hypoalbuminemia (<35 mg/l) were assigned a score of 2. Patients were assigned a score of 1 if presenting with only one of these abnormalities, and a score of 0 if neither of these abnormalities were present. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal seeding were analyzed. The results showed that the median overall survival (OS) of patients in the GPS 0 group was longer, compared with that in the GPS 1 and GPS 2 groups (15.50, vs. 10.07 and 7.97 months, respectively; P<0.001). No significant difference was found between the median OS of patients with a good performance status (ECOG <2) and those with a poor (ECOG ≥2) performance status (13.67, vs. 11.80 months; P= 0.076). In the subgroup analysis, the median OS in the GPS 0 group was significantly longer, compared with that in the GPS 1 and GPS 2 groups, for the patients receiving palliative chemotherapy and patients without palliative chemotherapy. Multivariate survival analysis demonstrated that CA19-9, palliative gastrectomy, first-line chemotherapy and GPS were the prognostic factors predicting OS. In conclusion, the GPS was superior to the subjective assessment of ECOG PS as a prognostic factor in predicting the outcome of gastric cancer with peritoneal seeding.

Patient selection in palliative surgery: Defining value

“…Blakely et al found no association of ECOG performance status greater than or equal to 2 with mortality. Yuan et al studied 384 patients with gastric cancer with peritoneal seeding and found no significant difference in survival using an ECOG performance status of 2 as the cut off for risk stratification . A GPS of greater than zero, however, was found to be superior to ECOG and associated with increased mortality in this study.…”

“…A point is assigned if the patient has an albumin of less than 3.5 g/dL in the presence of an elevated CRP or a CRP greater than 10 mg/L alone; patients are then classified as high (2 points), intermediate (1 point), or low (0 point) risk for postoperative mortality. This tool was originally designed to risk stratify patients undergoing colorectal cancer resections with curative intent but has since been validated in patients undergoing palliation for unresectable pancreaticobiliary cancers, metastatic colorectal cancers, and disseminated gastric cancer …”

“…As mentioned previously, the ECOG performance status is included in the composite LENT score and is an independent predictor of mortality in patients undergoing palliative colorectal resections . In addition, ECOG has been demonstrated to be predictive of mortality in patients undergoing surgery for intestinal perforation secondary to metastatic cancer, in patients undergoing any operation with palliative intent, and in patients with disseminated or locally advanced gastric cancer …”

REV‑ERBα reduction is associated with clinicopathological features and prognosis in human gastric cancer

“…None of the patients had received any other therapies, including radiotherapy or chemotherapy prior to surgery. The hepatic, renal and bone marrow functions of all patients were normal, and the Eastern Cooperative Oncology Group Performance Status scores were between 0–2 ( 8 ). Patients with abnormal function rest results, and those who were pregnant or breast-feeding were excluded.…”

Viennese risk prediction score for Advanced Gastroesophageal carcinoma based on Alarm Symptoms (VAGAS score): characterisation of alarm symptoms in advanced gastro-oesophageal cancer and its correlation with outcome

“…[22][23][24] Although frequently used, both scores seem to fail to provide a useful prognostic score for patients with gastro-oesophageal cancer and show a considerable variability depending on the physician who evaluates the score. [25][26][27] Since the usual alarm symptoms such as dysphagia or dyspepsia comprise a huge burden for everyday life but do not influence the overall performance of the patient right away, they do not have any effect on the results of the ECOG or Karnofsky score. That is why we surmised that these symptoms and signs may have great prognostic value for the performance and OS of patients with metastatic gastro-oesophageal cancer.…”