title: A prospective study of the role of inflammation in bladder cancer.
abstract: BACKGROUND
  To examine the role of inflammation in bladder cancer, we assessed the relationship between a systemic inflammation prognostic score (modified Glasgow Prognostic Score, mGPS), the tumor inflammatory cell infiltrate as measured by the Klintrup-Makinen score and tumor necrosis with cancer specific survival in patients with bladder cancer.
  
  
  METHODS
  The cohort consisted of 68 bladder cancer patients, 47 with localised disease and 21 with muscle invasive disease. The mGPS response was constructed by measuring C-reactive protein and albumin concentrations and the Klintrup-Makinen score was evaluated histologically for the local inflammatory response. Pathological parameters such as grade, T stage and tumor necrosis were also assessed.
  
  
  RESULTS
  Median follow was 47 months and 24 patients died of their disease. On univariate analysis, T stage (p < 0.001), grade (p < 0.001) and mGPS (p = 0.002) were significant predictors of cancer specific survival. On multivariate analysis, T stage (hazard ratio 5.98, 95% confidence interval 3.18-11.24, p < 0.001) and mGPS (hazard ratio 1.78, 95% confidence interval 1.09-2.9, p = 0.02) were significant independent predictors of cancer specific survival.
  
  
  CONCLUSIONS
  A preoperative systemic inflammatory response is an independent predictor of poor cancer specific survival in patients with bladder cancer.
authors.affiliation: Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Qayyum
authors.affiliation: Department of Urology, Royal Infirmary, Glasgow, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: McArdle
authors.affiliation: Department of Urology, Royal Infirmary, Glasgow, UK.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hilmy
authors.affiliation: University Department of Pathology, Royal Infirmary, Glasgow, UK.
authors.forename: James
authors.initials: J
authors.lastname: Going
authors.affiliation: Department of Pathology, Western Infirmary, Glasgow, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Orange
authors.affiliation: Department of Pathology, Western Infirmary, Glasgow, UK.
authors.forename: Morag
authors.initials: M
authors.lastname: Seywright
authors.affiliation: School of Medicine, College of MVLS, University of Glasgow, Royal Infirmary, Glasgow, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Horgan
authors.affiliation: Department of Urology, Royal Infirmary, Glasgow, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Underwood
authors.affiliation: Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Edwards
keywords: Bladder cancer; C-reactive protein; Glasgow prognostic score; Inflammation; Klintrup-Makinen score