title: Does the modified Glasgow Prognostic Score (mGPS) have a prognostic role in esophageal cancer?
abstract: BACKGROUND
  The modified Glasgow Prognostic Score (mGPS), which combines indices of decreased plasma albumin and elevated CRP, has reported independent prognostic significance in colorectal cancer, but its value in upper gastrointestinal cancer is unclear. The aim of this study was to assess the prognostic significance of mGPS in patients with operable esophageal malignancy.
  
  
  METHODS
  Patients undergoing resection with curative intent between January 2008 and June 2013 were included. The mGPS was scored as 0, 1, or 2 based on CRP(>10 mg/L) and albumin(<35g/L). The mGPS score (0 vs. 1/2 combined) was correlated with patient and tumor characteristics, and operative and oncologic outcomes.
  
  
  RESULTS
  Two hundred and twenty-three patients were included. Median (range) follow-up was 21(12-70) months. The mGPS was 0 in 174 patients(78%). mGPS was significantly associated with positive nodal status(P = 0.008) and stage ≥III (P = 0.017). There was a significant improvement in overall survival in patients with mGPS = 0 (47.8 vs. 37.5 months, P = 0.014) but in multivariate analysis, only TNM-stage and nodal status were found to be independent prognostic indicators.
  
  
  CONCLUSIONS
  mGPS is associated with advanced stage but has no independent prognostic significance and does not impact on operative outcomes. Consequently, this data does not support its routine application in patient selection or prognostication. J. Surg. Oncol. 2016;113:732-737. © 2016 Wiley Periodicals, Inc.
authors.affiliation: National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland.
authors.forename: Siun M
authors.initials: SM
authors.lastname: Walsh
authors.affiliation: National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Casey
authors.affiliation: National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland.
authors.forename: Raymond
authors.initials: R
authors.lastname: Kennedy
authors.affiliation: National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland.
authors.forename: Narayanasamy
authors.initials: N
authors.lastname: Ravi
authors.affiliation: National Centre for Esophageal and Gastric Cancer, St. James's Hospital, Dublin, Ireland.
authors.forename: John V
authors.initials: JV
authors.lastname: Reynolds
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016208:Databases, Factual; D004938:Esophageal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: adenocarcinoma of the esophagus; esophageal cancer; modified Glasgow Prognostic Score