Prognostic importance of the inflammation-based Glasgow prognostic score in patients with gastric cancer.
BACKGROUND
The inflammation-based Glasgow prognostic score (GPS) has been shown to be a prognostic factor for a variety of tumours. This study investigates the significance of the modified GPS (mGPS) for the prognosis of patients with gastric cancer.


METHODS
The mGPS (0=C-reactive protein (CRP) ≤ 10 mg l(-1), 1=CRP>10 mg l(-1) and 2=CRP>10 mg l(-1) and albumin<35 g l(-1)) was calculated on the basis of preoperative data for 1710 patients with gastric cancer who underwent surgery between January 2000 and December 2007. Patients were given an mGPS of 0, 1 or 2. The prognostic significance was analysed by univariate and multivariate analyses.


RESULTS
Increased mGPS was associated with male patient, old age, low body mass index, increased white cell count and neutrophils, elevated carcinoembryonic antigen and CA19-9 and advanced tumour stage. Kaplan-Meier analysis and log-rank test revealed that a higher mGPS predicted a higher risk of postoperative mortality in both relative early-stage (stage I; P<0.001) and advanced-stage cancer (stage II, III and IV; P<0.001). Multivariate analysis demonstrated the mGPS to be a risk factor for postoperative mortality (odds ratio 1.845; 95% confidence interval 1.184-2.875; P=0.007).


CONCLUSIONS
The preoperative mGPS is a simple and useful prognostic factor for postoperative survival in patients with gastric cancer.
Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
X
X
Jiang
N
N
Hiki
S
S
Nunobe
K
K
Kumagai
T
T
Kubota
S
S
Aikou
T
T
Sano
T
T
Yamaguchi
D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D018395:CA-19-9 Antigen / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000378:metabolism / Q000473:pathology*; D007958:Leukocyte Count; D008297:Male; D009367:Neoplasm Staging; D009504:Neutrophils / Q000378:metabolism; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood / Q000378:metabolism / Q000473:pathology*
D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D002097:C-Reactive Protein