Prognostic Utility of the Modified Glasgow Prognostic Score in Urothelial Carcinoma: Outcomes from a Pooled Analysis

Abstract

Background: Many studies explored the prognostic value of the modified Glasgow Prognostic Score (mGPS) in urothelial carcinoma (UC), but the results are controversial. This study aimed to quantify the relationship between pretreatment mGPS and survival in patients with UC. Methods: A systematic literature search was conducted using Embase, PubMed, and Web of Science to identify eligible studies published before August 2022. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the association between pretreatment mGPS and the prognosis of UC. Results: Thirteen eligible studies involving 12,524 patients were included. A high mGPS was significantly associated with poor overall survival (mGPS 1/0: HR = 1.33, 95% CI 1.12–1.58, p = 0.001; mGPS 2/0: HR = 2.02, 95% CI 1.43–2.84, p < 0.0001), progression-free survival (mGPS 1/0: HR = 1.26, 95% CI 1.03–1.53, p = 0.021; mGPS 2/0: HR = 1.76, 95% CI 1.12–2.77, p = 0.013), recurrence-free survival (mGPS 1/0: HR = 1.36, 95% CI 1.18–1.56, p < 0.0001; mGPS 2/0: HR = 1.70, 95% CI 1.44–2.000, p < 0.0001), and cancer-specific survival (mGPS 2/0: HR = 1.81, 95% CI 1.30–2.52, p < 0.0001). A subgroup analysis of OS also yielded similar results. Conclusions: Evidence suggests that high pretreatment mGPS in UC is closely related to poor survival. Pre-treatment mGPS is a powerful independent prognostic factor in patients with UC.

Prognostic value of pretreatment modified Glasgow Prognostic Score in small cell lung cancer: A meta-analysis

“…Tan et al included 13 studies involving 12,524 urothelial carcinoma patients and demonstrated that a high mGPS was obviously associated with poor OS (mGPS 0/1: HR = 1.33, P = .001; mGPS 0/2: HR = 2.02, P < .001) and PFS (mGPS 0/1: HR = 1.26, P = .021; mGPS 0/2: HR = 1.76, P = .013), recurrence-free survival (RFS) (mGPS 0/1: HR = 1.36, P < .001; mGPS 0/2: HR = 1.70, P < .001) and cancer-specific survival (mGPS 0/2: HR = 1.81, P < .001). [21] Besides, Wu et al [29,33,34,36,37] 1.81 0.96-3.41 .065 92.1 <.001 Japan 4 [30][31][32]35] 2.15 1.68-2.75 <.001 0.0 .953 Tumor stage Mixed 7 [29,30,33,34,[36][37][38] 1.77 1.20-2.63 .004 89.5 <.001 Extensive 3 [31,32,35] 2.37 1.57-3.58 <.001 0.0 .993 Treatment Mixed 3 [29,30,32] 2.66 1.59-4.46 <.001 57.4 .096 Chemotherapy 6 [31,[33][34][35][36][37] 1.68 1.00-2.82 .052 88.7 <.001 Comparison of mGPS mGPS 0 vs 1 5 [29,30,32,33,38] 1.31 1.16-1.49 <.001 0.0 .902 mGPS 0 vs 2 5 [29,30,32,33,38] 2.75 1.77-4.28 <.001 81.3 <.001 Progression-free survival 3 [31,34,35] 1.40 1.13-1.74 .002 ...…”

“…Tan et al included 13 studies involving 12,524 urothelial carcinoma patients and demonstrated that a high mGPS was obviously associated with poor OS (mGPS 0/1: HR = 1.33, P = .001; mGPS 0/2: HR = 2.02, P < .001) and PFS (mGPS 0/1: HR = 1.26, P = .021; mGPS 0/2: HR = 1.76, P = .013), recurrence-free survival (RFS) (mGPS 0/1: HR = 1.36, P < .001; mGPS 0/2: HR = 1.70, P < .001) and cancer-specific survival (mGPS 0/2: HR = 1.81, P < .001). [ 21 ] Besides, Wu et al also manifested that an elevated mGPS predicted poor OS in patients with pancreatic cancer (HR = 1.92, P = .002). [ 20 ] Tong et al enrolled 2691 patients from 15 cohort studies and indicated that mGPS was significantly associated with OS of renal cell carcinoma (mGPS 0/1: HR = 2.64, P = .002; mGPS 0/2: HR = 3.75, P < .001).…”

“…[17] Up to now, its prognostic value has been verified by the systematic review and meta-analysis in several types of cancers including the urothelial carcinoma, ovarian cancer, pancreatic cancer, renal cell carcinoma, and gynecologic cancer. [18][19][20][21][22] As for lung cancer, Jin et al conducted a meta-analysis to verify prognostic value of mGPS in lung cancer after including 11 studies in 2017. [23] However, they did not well identify the prognostic role of pretreatment mGPS in SCLC and the association between pretreatment mGPS and survival of SCLC patients remains unclear now.…”

Prognostic values of systemic inflammation and nutrition‐based prognostic indices in oropharyngeal carcinoma

“…Although meta‐analyses of the prognostic value of pretreatment GPS or mGPS in several cancer types have been reported, 30 , 31 , 32 , 33 , 34 no meta‐analysis has been reported for head and neck cancers. Furthermore, no meta‐analysis on the HS‐mGPS is available.…”