The Glasgow Prognostic Score, an inflammation based prognostic score, predicts survival in patients with hepatocellular carcinoma

Kinoshita, Akiyoshi; Onoda, Hiroshi; Imai, Nami; Iwaku, Akira; Oishi, Mutumi; Tanaka, Ken; Fushiya, Nao; Koike, Kazuhiko; Nishino, Hitoo; Matsushima, Masato; Saeki, Chisato; Tajiri, Hisao

doi:10.1186/1471-2407-13-52

Cited by 90 publications

(93 citation statements)

References 28 publications

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“…In the same meta-analysis, pooled analysis demonstrated that poor OS and RFS in HCC was significantly associated with CRP ≥10 mg/L, with a HR of 2.15 and 2.66 respectively. Similarly, Kinoshita et al, in two separate studies investigating scoring systems driven by CRP (83,84), again demonstrated the strong correlation between extent and stage of disease and the Glasgow prognostic score (GPS) and CRP/albumin ratio. One hundred and fifty individuals with newly diagnosed HCC at various stages were prospectively followed and divided based on their GPS and modified GPS.…”

Section: C-reactive Protein (Crp)mentioning

confidence: 79%

“…The value of CRP in HCC prognostication has been duplicated and confirmed in various stages of the disease (78,83). It has not only been shown to be predictive of tumor characteristics histologically, but also a useful tool in predicting response to various treatment options and longterm survival afterwards (83,84).…”

Section: C-reactive Protein (Crp)mentioning

confidence: 94%

“…One hundred and fifty individuals with newly diagnosed HCC at various stages were prospectively followed and divided based on their GPS and modified GPS. A higher GPS significantly correlated with tumor number, vascular invasion, maximal tumor diameter and frequency of extra hepatic metastasis (83). In the second study, which retrospectively investigated incorporating albumin with CRP using the CRP/albumin ratio to improve the prognostic value of both markers, the CRP/albumin ratio, based on a cutoff of <0.037, was associated with larger tumor size and vascular invasion.…”

Section: C-reactive Protein (Crp)mentioning

confidence: 99%

“…It has not only been shown to be predictive of tumor characteristics histologically, but also a useful tool in predicting response to various treatment options and longterm survival afterwards (83,84).…”

Section: C-reactive Protein (Crp)mentioning

confidence: 99%

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Role of inflammatory markers as hepatocellular cancer selection tool in the setting of liver transplantation

Rosenblatt

Tafesh

Halazun

2017

Transl. Gastroenterol. Hepatol.

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Since the advent of the Milan criteria in 1996 and its widespread adoption for selection of patients with hepatocellular carcinoma (HCC) who would benefit from transplant, there has been an extensive hunt for the ideal clinical biomarker to predict HCC recurrence. This is because Milan lack does not include tumor biology indices and recurrence rates remain in the 15-20% range worldwide. While a 'silver-bullet' biomarker has not been found, several useful inflammatory markers have been identified and used in scoring systems that supersede Milan in their ability to predict HCC recurrence post liver transplantation (LT). In this review, we aim to summarize the role of inflammatory markers paly in the selection of HCC patients awaiting LT. measured characteristic to indicate a biological process or response (19). They have the potential to assess the risk of recurrence in HCC without invasive testing, offering yet another tool in a physician's armamentarium to identify the patients who would benefit from LT and those who would not. Currently, several biomarkers are utilized in clinical practice, but both the AASLD and an international consensus (15,20) describe biomarkers as an area of future study. Alpha fetoprotein (AFP) (21)(22)(23)(24) and proteins induced by vitamin K absence II (PIVKA-II) (25-28) have been extensively studied and validated as predictors of HCC outcomes. However, there are patients who do not produce either biomarker and still have high risk of recurrence (29,30). Therefore, pursuing other biomarkers that assess the role of inflammation in malignancy is another method to identify patients at risk of recurrence. The link between inflammation and cancer was postulated in the year 1863 by Virchow, and inflammation has been linked with several gastrointestinal malignancies (31). In the last decade, there has been increasing interest in the use of inflammatory markers as tools to predict poor outcomes in patients with HCC. This review will focus of such inflammatory markers, the role they play in HCC, and how to potentially use these as selection tools for patients awaiting transplant. Neutrophil lymphocyte ratio (NLR)The NLR is a measure of the proportion of peripheral blood neutrophils to lymphocytes and has an important role in predicting outcomes in several malignancies. An elevated NLR can be a marker of both neutrophilia in response to inflammation or peripheral lymphopenia, both first demonstrated the use of NLR in predicting outcomes for HCC in 150 patients undergoing LT for HCC. Of the 13 patients with elevated NLR, 62% had recurrence and, as a cohort, had significantly worse OS and RFS. Of note, even patients within Milan criteria with an elevated NLR, compared to those with normal NLR, had a significantly worse survival (30% vs. 81%) (36). In the largest study in the MELD era from the United States examining post-LT outcomes for HCC, the MORAL score was evaluated for its ability to predict post-LT RFS. The MORAL score was constructed using Cox-regression analyses for factors imp...

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Section: C-reactive Protein (Crp)mentioning

confidence: 79%

Section: C-reactive Protein (Crp)mentioning

confidence: 94%

Section: C-reactive Protein (Crp)mentioning

confidence: 99%

Section: C-reactive Protein (Crp)mentioning

confidence: 99%

See 2 more Smart Citations

Role of inflammatory markers as hepatocellular cancer selection tool in the setting of liver transplantation

Rosenblatt

Tafesh

Halazun

2017

Transl. Gastroenterol. Hepatol.

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“…Accumulating evidence indicates the prospective of inflammation-based parameters as prognostic factors (12). This is supported by the wide range of associations between inflammation and tumour initiation, invasion and metastasis (13,14).…”

Section: Introductionmentioning

confidence: 94%

Glasgow Prognostic Score predicts prognosis of intrahepatic cholangiocarcinoma

Qin

Zhang

et al. 2017

Molecular and Clinical Oncology

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Abstract. High Glasgow Prognostic Score (GPS) has been associated with poor prognosis in patients with lung, ovarian, colorectal and renal cancer, as well as hepatocellular carcinoma. The aim of this study was to investigate the prognostic value of GPS in patients with intrahepatic cholangiocarcinoma (ICC) undergoing partial hepatectomy. A total of 72 patients with pathologically confirmed ICC were classified according to their GPS scores assigned based on the preoperative levels of C-reactive protein (CRP) and albumin. Their clinicopathological data were retrospectively assessed using univariate and multivariate analysis to determine their association with overall survival and recurrence. High GPS scores in ICC patients were associated with preoperative levels of CRP (P<0.001) and albumin (P<0.001), frequency of ascites accumulation (P=0.035), lymph node metastasis (P=0.002) and tumour size (P=0.005). On univariate analysis, preoperative levels of CRP (P<0.001), albumin (P=0.016) and carbohydrate antigen 19-9 (P=0.038), hepatitis B virus (HBV) positivity (P=0.009), occurrence of lymph node metastasis (P=0.001), Child-Pugh class B (P=0.013) and high tumour-node-metastasis (TNM) stage (P=0.002) were found to be associated with the 1-and 3-year overall survival. Multivariate analysis suggested that GPS score (HR=2.037, 95% CI: 1.092-3.799, P=0.025), TNM classification (HR=2.000, 95% CI: 1.188-3.367, P=0.009) and HBV positivity (HR=0.559 95% CI: 0.328-0.953, P=0.032) were independently associated with patient survival. High GPS scores also predicted ICC recurrence. In conclusion, our results demonstrated that GPS may serve as an independent marker of prognosis in patients with ICC following partial hepatectomy.

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Prognostic value of preoperative inflammatory ratios in early glottic cancer treated with transoral laser surgery

Juesas Iglesias,

Sánchez‐Canteli,

Pedregal Mallo

et al. 2024

Head & Neck

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BackgroundThere is growing evidence regarding the prognostic utility of ratios such as neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and systemic immune‐inflammatory index (SIII) in head and neck squamous cell carcinoma (HNSCC). However, most studies to date include heterogeneous series with different treatments or tumor subsites.MethodsWe collected data from 201 patients with stage I–II glottic squamous cell carcinoma treated with transoral laser surgery. NLR, PLR, and SIII were calculated from preoperative cell blood count, cut‐off points were obtained by ROC curve analysis, and survival rates were calculated.ResultsHigh NLR (p = 0.012) and SIII (p = 0.037), but not PLR (p = 0.48), were associated with worse disease‐specific survival (DSS). A similar trend was observed with overall survival (OS), although it did not reach statistical significance. On multivariable analyses, both high NLR (HR = 3.8, 95% CI = 1.5–9.9, p = 0.006) and high SIII (HR = 2.77, 95% CI = 1.1–6.9, p = 0.03) were significantly associated with shortened DSS.ConclusionsPreoperative NLR and SIII emerge as independent prognostic biomarkers for early‐stage surgically treated glottic tumors and could guide individualized follow‐up.

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The Glasgow Prognostic Score, an inflammation based prognostic score, predicts survival in patients with hepatocellular carcinoma

Cited by 90 publications

References 28 publications

Role of inflammatory markers as hepatocellular cancer selection tool in the setting of liver transplantation

Role of inflammatory markers as hepatocellular cancer selection tool in the setting of liver transplantation

Glasgow Prognostic Score predicts prognosis of intrahepatic cholangiocarcinoma

Prognostic value of preoperative inflammatory ratios in early glottic cancer treated with transoral laser surgery

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