title: The high-sensitivity modified Glasgow prognostic score is superior to the modified Glasgow prognostic score as a prognostic predictor in patients with resectable gastric cancer.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the superiority of the high-sensitivity modified Glasgow prognostic score (HS-mGPS) before surgery in patients with gastric cancer.
  
  
  METHODS
  The participants of this retrospective study comprised 552 patients with gastric cancer who underwent gastrectomy at the Fukuoka University Hospital. The HS-mGPS was calculated before surgery based on cutoff values of 0.3 mg/dl for C-reactive protein and 3.5 g/dl for albumin, and correlations between the HS-mGPS and the clinicopathological parameters and prognosis were evaluated. In addition, the superiority of the HS-mGPS to the mGPS as a prognostic indicator was examined in detail.
  
  
  RESULTS
  The mGPS was 0 in 494 patients, 1 in 24 patients and 2 in 34 patients. In contrast, the HS-mGPS was 0 in 411 patients, 1 in 75 patients and 2 in 66 patients. Both the mGPS (p < 0.0001) and HS-mGPS (p < 0.0001) were good prognostic predictors in gastric cancer patients who underwent gastrectomy. Of the 494 patients with an mGPS of 0 before surgery, 51 and 32 exhibited an HS-mGPS of 1 and 2, respectively. The patients who exhibited migration in the HS-mGPS demonstrated a significantly more unfavorable prognosis than the patients with an HS-mGPS of 0 (p < 0.0001). The prognostic impact of the HS-mGPS was especially clear in stage I and IV patients (p = 0.0027, p = 0.017). The HS-mGPS was found to be a superior prognostic predictor compared to the mGPS in a multivariate analysis (p = 0.0002).
  
  
  CONCLUSIONS
  The HS-mGPS before surgery is a superior prognostic predictor in patients with gastric cancer.
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Takeno
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shibata
authors.forename: Kenji
authors.initials: K
authors.lastname: Maki
authors.forename: Hironari
authors.initials: H
authors.lastname: Shiwaku
authors.forename: Ippei
authors.initials: I
authors.lastname: Yamana
authors.forename: Risako
authors.initials: R
authors.lastname: Yamashita
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein