title: Evaluation of an inflammation-based prognostic score in patients with inoperable pancreatic cancer.
abstract: OBJECTIVE
  Patients with pancreatic cancer have one of the poorest survival rates and selection of patients for active treatment remains problematical. The present study assesses the value of an inflammation-based score (Glasgow Prognostic Score, GPS) in patients with inoperable pancreatic cancer.
  
  
  METHODS
  The GPS was constructed as follows: patients with both an elevated C-reactive protein (>10 mg/l) and hypoalbuminaemia (<35 g/l) were allocated a score of 2. Patients in whom only 1 or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively.
  
  
  RESULTS
  One hundred and eighty-seven patients were studied and 49 (26%) underwent an operative palliative bypass procedure. At the end of follow-up, 181 (97%) patients died, 17% of patients were alive at 12 months. On univariate analysis, age (p < 0.01), TNM stage (p < 0.001) and the GPS (p < 0.001) were significant predictors of survival. On multivariate survival analysis, stratified for bypass procedure, age (hazard ratio 1.53, 95%CI 1.12-2.10, p = 0.008), TNM stage (hazard ratio 1.70, 95%CI 1.33-2.18, p < 0.001) and the GPS (hazard ratio 1.72, 95%CI 1.40-2.11, p < 0.001) remained independent significant predictors of survival.
  
  
  CONCLUSIONS
  At diagnosis, the presence of a systemic inflammatory response (as measured by the GPS) appears to be a useful indicator of poor outcome, independent of TNM stage, in patients with inoperable pancreatic cancer.
authors.affiliation: University Department of Surgery, Royal Infirmary, Glasgow, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Glen
authors.forename: Nigel B
authors.initials: NB
authors.lastname: Jamieson
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
authors.forename: Ross
authors.initials: R
authors.lastname: Carter
authors.forename: Clem W
authors.initials: CW
authors.lastname: Imrie
authors.forename: Colin J
authors.initials: CJ
authors.lastname: McKay
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D016019:Survival Analysis