Prognostication in advanced cancer: a study examining an inflammation-based score.
BACKGROUND
Prognostication in advanced cancer is challenging. Biomarkers of systemic inflammation (C-reactive protein and albumin) combined in the modified Glasgow Prognostic Score (mGPS) have been used to assist prognostication in various cancer types.


OBJECTIVE
The aim of this study was to examine whether an inflammation-based prognostic score (mGPS) is useful in prognostication in advanced cancer patients.


METHODS
Cancer patients who had biomarkers (C-reactive protein and albumin) recorded were allocated an mGPS ranging from 0-2. Groups were compared using Jonckheere-Terpstra and Chi-squared tests. Survival analyses were carried out using Kaplan-Meier and multivariate Cox regression models.


RESULTS
A total of 296 patients were included, and a representative subgroup of 102 had biomarkers recorded. The mGPS was predictive of death (P=0.014) adjusted for sex, cancer site, age, hemoglobin, and white cell count. Patients with an mGPS of 2 had 2.7 times the risk of death of those with an mGPS of 0 (P=0.011). Patients with an mGPS less than 2 had an 86.1% and 74.3% chance of being alive at two and four weeks, respectively.


CONCLUSIONS
A role for the mGPS in prognostication near the end of life is suggested. Biomarkers (e.g., mGPS) may assist clinical decisions as to whether intensive treatments are appropriate and may facilitate end-of-life care planning.
St. Columba's Hospice, Edinburgh, United Kingdom.
Michael
M
Partridge
Marie
M
Fallon
Caroline
C
Bray
Donald
D
McMillan
Duncan
D
Brown
Barry
B
Laird
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D007958:Leukocyte Count; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D013727:Terminal Care
D015415:Biomarkers; D006454:Hemoglobins; D012709:Serum Albumin; D002097:C-Reactive Protein