title: Glasgow prognostic score predicts prognosis for cancer patients in palliative settings: a subanalysis of the Japan-prognostic assessment tools validation (J-ProVal) study.
abstract: OBJECTIVE
  The Glasgow prognostic score (GPS), which uses C-reactive protein and albumin levels, is a good predictor of prognosis in cancer patients undergoing anti-tumor therapy. The objective of this study was to investigate the correlation between GPS and survival among cancer patients in palliative settings, as findings in such populations have not been well described.
  
  
  METHODS
  This was a subanalysis of a multicenter, prospective, cohort study in patients who were adults, diagnosed with advanced cancer, and first referred to palliative care service in Japan. Patients who were not receiving anti-tumor therapy and who had undergone laboratory examinations were eligible. Clinical features were analyzed to investigate prognostic factors.
  
  
  RESULTS
  A total of 1160 patients were enrolled (41.6 % female; median age, 72 years). The independent predictors were Eastern Cooperative Oncology Group performance status (ECOG PS) score of 4 (hazard ratio (HR), 1.54), liver metastasis (HR, 1.21), dyspnea (HR, 1.35), edema (HR, 1.25), prognostic performance index (HR, 1.56), neutrophil-lymphocyte ratio (HR, 1.43), and GPS of 2 (HR, 1.36). The sensitivity and specificity for 3-week prognosis of a GPS of 2 were 0.879 and 0.410. Median survival time with GPS of 0, 1, and 2 was 58 days (95 % confidence interval, 48-81), 43 days (37-50), and 21 days (19-24), respectively (log-rank test, p < 0.001).
  
  
  CONCLUSIONS
  The GPS was a good prognostic indicator for cancer patients in palliative settings.
authors.affiliation: Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. tomiura@east.ncc.go.jp.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Miura
authors.affiliation: Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. yosmatsu@east.ncc.go.jp.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan. Japanhamat1971@gmail.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hama
authors.affiliation: Department of Palliative Medicine,, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan. kojiamamo4813@gmail.com.
authors.forename: Koji
authors.initials: K
authors.lastname: Amano
authors.affiliation: Seirei Hospice, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu City, Shizuoka, 433-8558, Japan. y-jeong680909@ktb.biglobe.ne.jp.
authors.forename: Yo
authors.initials: Y
authors.lastname: Tei
authors.affiliation: Department of Oncology, Mitsubishi Kyoto Hospital, Goshocho 1 Katsura, Nishikyoku, Kyoto, 615-8087, Japan. xxayaccinoxx@gmail.com.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kikuchi
authors.affiliation: Department of Palliative Medicine, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga, Shizuoka, 422-8527, Japan. akihikosuga@gmail.com.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Suga
authors.affiliation: Tsukuba Medical Center Foundation, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan. hisanaga@tmch.or.jp.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hisanaga
authors.affiliation: Palliative Care Department, Okayama Saiseikai General Hospital, 1-17-18 Ifukucho, Kita-ku, Okayama City, Okayama, 700-8511, Japan. tishihara@saiseidr.jp.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Ishihara
authors.affiliation: Matsue City Hospital, 32-1 Noshira-cho, Matsue City, Shimane, 690-8509, Japan. abemama@lime.ocn.ne.jp.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cho, Shinjuku, Tokyo, 162-8543, Japan. kankannjp@yahoo.co.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kaneishi
authors.affiliation: Aozora Clinic, 2-357 Midorigaoka, Matsudo City, Chiba, 271-0074, Japan. kawagoe@aozora-clinic.org.
authors.forename: Shohei
authors.initials: S
authors.lastname: Kawagoe
authors.affiliation: Department of Palliative Medicine, Wakayama Medical University Hospital Oncology Center, 811-1 Kimiidera, Wakayama, 641-8509, Japan. kuriyama@wakayama-med.ac.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kuriyama
authors.affiliation: Department of Palliative Care, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. takashi_maeda@hotmail.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Gratia Hospital Hospice, 6-14-1 Aomadaninishi, Mino, Osaka, 562-8567, Japan. mori.ichi.mail@gmail.com.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mori
authors.affiliation: Department of Palliative Medicine, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8574, Japan. nakajy@dream.ocn.ne.jp.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Nakajima
authors.affiliation: Kawasaki Comprehensive Care Center, Kawasaki Municipal Ida Hospital, 2-27-1 Ida, Nakahara-ku, Kawasaki, Kanagawa, 211-0035, Japan. ayurveda-pk@hotmail.co.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nishi
authors.affiliation: Department of Palliative Care, St. Luke's International Hospital, Tokyo, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. sakurahr2004@gmail.com.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakurai
authors.affiliation: Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu City, Shizuoka, 433-8558, Japan. tmorita@sis.seirei.or.jp.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. hikinosh@east.ncc.go.jp.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis*; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D010166:Palliative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D000418:Albumins; D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: Albumin; C-reactive protein; Cancer; Glasgow prognostic score; Inflammation; Palliative care; Prognosis