Modified Glasgow Prognostic Score is Associated With Risk of Recurrence in Bladder Cancer Patients After Radical Cystectomy

Abstract

Recently, many studies explored the role of inflammation parameters in the prognosis of urinary cancers, but the results were not consistent. The modified Glasgow Prognostic Score (mGPS), a systemic inflammation marker, is a prognostic marker in various types of cancers. The aim of the present study was to investigate the usefulness of the preoperative mGPS as predictor of recurrence-free (RFS), overall (OS), and cancer-specific (CSS) survivals in a large cohort of urothelial bladder cancer (UBC) patients.A total of 1037 patients with UBC were included in this study with a median follow-up of 22 months (range 3–60 months). An mGPS = 0 was observed in 646 patients (62.3%), mGPS = 1 in 297 patients (28.6 %), and mGPS = 2 in 94 patients (9.1%).In our study cohort, subjects with an mGPS equal to 2 had a significantly shorter median RFS compared with subjects with mGPS equal to 1 (16 vs 19 months, hazard ratio [HR] 1.54, 95% CI 1.31–1.81, P < 0.001) or with subjects with mGPS equal to 0 (16 vs 29 months, HR 2.38, 95% CI 1.86–3.05, P < 0.001). The association between mGPS and RFS was confirmed by weighted multivariate Cox model. Although in univariate analysis higher mGPS was associated with lower OS and CSS, this association disappeared in multivariate analysis where only the presence of lymph node-positive bladder cancer and T4 stage were predictors of worse prognosis for OS and CSS.In conclusion, the mGPS is an easily measured and inexpensive prognostic marker that was significantly associated with RFS in UBC patients.

Prognostic significance of pretreatment albumin/globulin ratio in patients with hepatocellular carcinoma

“…The inflammation-based prognostic score such as Glasgow prognostic score,19 neutrophil-to-lymphocyte ratio,20 aspartate aminotransferase-to-platelet ratio,21 and platelet-to-lymphocyte ratio22 was proven to be independent prognostic parameters by previous studies. However, there are still some limitations for the use of these prognostic scores in patients with HCC.…”

Easily Available Blood Test Neutrophil-To-Lymphocyte Ratio Predicts Progression in High-Risk Non-Muscle Invasive Bladder Cancer

“…The modified Glasgow Prognostic Score (mGPS), a systemic inflammation marker, was found as a prognostic marker for recurrence in patients with urothelial bladder (22). On the other hand, bladder epithelium and bladder cancer cells express CD44 that binds glycosaminoglycans (GAG) such as chondroitin sulphate (CS).…”

Role of systemic inflammatory response markers in urological malignancy

“…A summary of six studies investigating the prognostic role of GPS/mGPS in UC is shown in Table . Four studies examined patients with bladder cancer, and two studies examined patients with upper tract UC.…”

“…A summary of six studies investigating the prognostic role of GPS/mGPS in UC is shown in Table 6. [69][70][71][72][73][74] Four studies 71,73 Four studies showed a prognostic value of GPS/mGPS in relation to OS or RFS: increased GPS/mGPS was significantly associated with worse prognosis. Lucca et al evaluated the association between non-organ-confined disease and several SIR markers including NLR, PLR, MLR, PNI and GPS in patients who underwent radical cystectomy.…”