title: Evaluation of an inflammation-based prognostic score in patients with metastatic renal cancer.
abstract: BACKGROUND
  Recently, it was shown that an inflammation-based prognostic score, the Glasgow Prognostic Score (GPS), provides additional prognostic information in patients with advanced cancer. The objective of the current study was to examine the value of the GPS compared with established scoring systems in predicting cancer-specific survival in patients with metastatic renal cancer.
  
  
  METHODS
  One hundred nineteen patients who underwent immunotherapy for metastatic renal cancer were recruited. The Memorial Sloan-Kettering Cancer Center (MSKCC) score and the Metastatic Renal Carcinoma Comprehensive Prognostic System (MRCCPS) score were calculated as described previously. Patients who had both an elevated C-reactive protein level (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a GPS of 2. Patients who had only 1 of those 2 biochemical abnormalities were allocated a GPS of 1. Patients who had neither abnormality were allocated a GPS of 0.
  
  
  RESULTS
  On multivariate analysis of significant individual factors, only calcium (hazard ratio [HR], 3.21; 95% confidence interval [95% CI], 1.51-6.83; P = .002), white cell count (HR, 1.66; 95% CI, 1.17-2.35; P = .004), albumin (HR, 2.63; 95% CI, 1.38-5.03; P = .003), and C-reactive protein (HR, 2.85; 95% CI; 1.49-5.45; P = .002) were associated independently with cancer-specific survival. On multivariate analysis of the different scoring systems, the MSKCC (HR, 1.88; 95% CI, 1.22-2.88; P = .004), the MRCCPS (HR, 1.42; 95% CI, 0.97-2.09; P = .071), and the GPS (HR, 2.35; 95% CI, 1.51-3.67; P < .001) were associated independently with cancer-specific survival.
  
  
  CONCLUSIONS
  An inflammation-based prognostic score (GPS) predicted survival independent of established scoring systems in patients with metastatic renal cancer.
authors.affiliation: Department of Urology, Gartnavel General Hospital, Glasgow, United Kingdom. sara_l_ramsey@ntlworld.com
authors.forename: Sara
authors.initials: S
authors.lastname: Ramsey
authors.forename: Gavin W A
authors.initials: GW
authors.lastname: Lamb
authors.forename: Michael
authors.initials: M
authors.lastname: Aitchison
authors.forename: John
authors.initials: J
authors.lastname: Graham
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis*; D007680:Kidney Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011237:Predictive Value of Tests; D011379:Prognosis; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein