title: The modified Glasgow prognosis score predicts for overall and disease-free survival following cytoreductive surgery and HIPEC in patients with pseudomyxoma peritonei of appendiceal origin.
abstract: BACKGROUND
  The modified Glasgow prognostic score (incorporating C-reactive protein and albumin) predicts survival in patients with gastro-intestinal tract cancer but has not been evaluated in patients with peritoneal malignancy. The aim was to evaluate the modified Glasgow score preoperatively in patients undergoing complete cytoreductive surgery (CCRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP) of appendiceal origin.
  
  
  METHODS
  Prospectively collected data from patients with PMP of appendiceal origin following CCRS and HIPEC between January 2007 and December 2011 were analysed. The mGPS was calculated from preoperative C-reactive protein and albumin. Predicted overall survival (OS) and disease-free survival (DFS) for each mGPS score were calculated using the Kaplan-Meier model. In a separate analysis, a comparison was made between mGPS and Tumour Markers (TM).
  
  
  RESULTS
  260 patients were included in the study. The mGPS of 0, 1, and 2 were found in 111, 130, and 19 patients respectively. The median follow-up was 48 months. For mGPS-0, -1, and -2, the predicted OS was 82.2, 73.7, and 69.2 months and the DFS was 73.5, 62.9, and 54.4 months respectively. As mGPS increases, there is a reduction in long-term survival. There was no difference between mGPS and TM.
  
  
  CONCLUSIONS
  Preoperative mGPS may be a cost effective prognostic tool for predicting OS and DFS in patients following complete CRS-HIPEC, and performs well compared to TM for predicting patients at high risk of recurrence.
authors.affiliation: Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UK.
authors.forename: G H C
authors.initials: GH
authors.lastname: Tan
authors.affiliation: Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Novo
authors.affiliation: Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UK.
authors.forename: S
authors.initials: S
authors.lastname: Dayal
authors.affiliation: Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UK.
authors.forename: K
authors.initials: K
authors.lastname: Chandrakumaran
authors.affiliation: Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UK.
authors.forename: F
authors.initials: F
authors.lastname: Mohamed
authors.affiliation: Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UK.
authors.forename: T
authors.initials: T
authors.lastname: Cecil
authors.affiliation: Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UK. Electronic address: brendan.moran@hhft.nhs.uk.
authors.forename: B J
authors.initials: BJ
authors.lastname: Moran
mesh_terms: D000368:Aged; D001063:Appendiceal Neoplasms / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: CRS and HIPEC; Modified Glasgow prognostic score; Pseudomyxoma peritonei; mGPS