The prognostic value of modified Glasgow Prognostic Score in lung cancer patients_West China Medical Journal

Authors：

DAI Sisi , QIU Zhixin , LI Lei ,  LI Weimin

Department of Respiratory and Critical Care Medicine, West China Hospital / West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Weimin, Email: weimin003@163.com

Keywords：

Lung cancer; Modified Glasgow Prognostic Score; Overall survival; Prognosis

DOI：

10.7507/1002-0179.201911148

Video：

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Objective To explore the prognostic value of modified Glasgow Prognostic Score (mGPS) in lung cancer patients.Methods The clinical data and follow-up information of patients with lung cancer diagnosed for the first time in West China Hospital of Sichuan University from August 2008 to May 2013 were retrospectively analyzed. Overall survival (OS) of patients with different mGPS were compared by Kaplan-Meier test and log-rank test. Univariate and multivariate Cox proportional hazard analysis were performed, and hazard ratio (HR) and 95% confidence interval (CI) were counted to evaluate the predictive value of different prognostic factors in patients with lung cancer.Results A total of 289 patients were included. According to the mGPS score, 127 patients had 0 point, 90 patients had 1 point, and 72 patients had 2 points. The OS of lung cancer patients with mGPS=0 was better than that of patients with mGPS=1 and mGPS=2 (P<0.001). Cox proportional hazards of univariate analysis revealed that age< 65 (P=0.022), stage for Ⅰand Ⅱ (P<0.001), surgery (P<0.001), chemotherapy (P=0.018), and mGPS=0 (1 vs. 0, P=0.008; 2 vs. 0, P<0.001) were the protective factors for lung cancer patients (P<0.05). Multiple-factor analysis showed that age [HR=0.680, 95%CI (0.508, 0.911), P=0.010], stage [HR=0.580, 95%CI (0.359, 0.939), P=0.027], operation [HR=0.254, 95%CI (0.140, 0.459), P<0.001], chemotherapy [HR=0.624, 95%CI (0.435, 0.893), P=0.010], mGPS (1 vs. 0) [HR=1.548, 95%CI (1.101, 2.176), P=0.012] and mGPS (2 vs. 0) [HR=1.425, 95%CI (1.003, 2.024), P=0.048] were independent predictors of OS in patients with lung cancer.Conclusion mGPS could be considered as an independent prognostic factor in lung cancer.

Citation： DAI Sisi, QIU Zhixin, LI Lei, LI Weimin. The prognostic value of modified Glasgow Prognostic Score in lung cancer patients. West China Medical Journal, 2020, 35(1): 5-10. doi: 10.7507/1002-0179.201911148 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2.	Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet, 2018, 391(10125): 1023-1075.
3.	Walker MJ, Zhou C, Backen A, et al. Discovery and validation of predictive biomarkers of survival for non-small cell lung cancer patients undergoing radical radiotherapy: two proteins with predictive value. EBioMedicine, 2015, 2(8): 841-850.
4.	Noonan SA, Patil T, Gao D, et al. Baseline and on-treatment characteristics of serum tumor markers in stage Ⅳ oncogene-addicted adenocarcinoma of the lung. J Thorac Oncol, 2018, 13(1): 134-138.
5.	Kinoshita T, Ohtsuka T, Yotsukura M, et al. Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stageⅠadenocarcinoma and squamous cell carcinoma of the lung. J Thorac Oncol, 2015, 10(4): 619-628.
6.	Holdenrieder S, Wehnl B, Hettwer K, et al. Carcinoembryonic antigen and cytokeratin-19 fragments for assessment of therapy response in non-small cell lung cancer: a systematic review and meta-analysis. Br J Cancer, 2017, 116(8): 1037-1045.
7.	Colotta F, Allavena P, Sica A, et al. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinogenesis, 2009, 30(7): 1073-1081.
8.	Wisastra R, Dekker FJ. Inflammation, cancer and oxidative lipoxygenase activity are intimately linked. Cancers (Basel), 2014, 6(3): 1500-1521.
9.	Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol, 2018, 9: 754.
10.	Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial, 2004, 17(6): 432-437.
11.	Pastorino U, Morelli D, Leuzzi G, et al. Baseline and postoperative C-reactive protein levels predict long-term survival after lung metastasectomy. Ann Surg Oncol, 2019, 26(3): 869-875.
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13.	McMillan DC, Crozier JE, Canna K, et al. Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis, 2007, 22(8): 881-886.
14.	Schoenberg MB, Anger HJW, Hao J, et al. Development of novel biological resection criteria for safe and oncologically satisfying resection of hepatocellular carcinoma. Surg Oncol, 2018, 27(4): 663-673.
15.	Walsh SM, Casey S, Kennedy R, et al. Does the modified Glasgow Prognostic Score (mGPS) have a prognostic role in esophageal cancer?. J Surg Oncol, 2016, 113(7): 732-737.
16.	Wen J, Bedford M, Begum R, et al. The value of inflammation based prognostic scores in patients undergoing surgical resection for oesophageal and gastric carcinoma. J Surg Oncol, 2018, 117(8): 1697-1707.
17.	Cox PR. The Aging of populations and its economic and social implications. Royal Statistical Society, 1958, 121(2): 253-254.
18.	Detterbeck FC, Boffa DJ, Kim AW, et al. The eighth edition lung cancer stage classification. Chest, 2017, 151(1): 193-203.
19.	Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell, 2011, 144(5): 646-674.
20.	Balkwill FR, Mantovani A. Cancer-related inflammation: common themes and therapeutic opportunities. Semin Cancer Biol, 2012, 22(1): 33-40.
21.	Bromberg J, Wang TC. Inflammation and cancer: IL-6 and STAT3 complete the link. Cancer Cell, 2009, 15(2): 79-80.
22.	Ruffell B, Affara NI, Coussens LM. Differential macrophage programming in the tumor microenvironment. Trends Immunol, 2012, 33(3): 119-126.
23.	Cannon NA, Meyer J, Iyengar P, et al. Neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic factors after stereotactic radiation therapy for early-stage non-small-cell lung cancer. J Thorac Oncol, 2015, 10(2): 280-285.
24.	Kang MH, Go SI, Song HN, et al. The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer, 2014, 111(3): 452-460.
25.	Ni XF, Wu J, Ji M, et al. Effect of C-reactive protein/albumin ratio on prognosis in advanced non-small-cell lung cancer. Asia Pac J Clin Oncol, 2018, 14(6): 402-409.
26.	Chaturvedi AK, Caporaso NE, Katki HA, et al. C-reactive protein and risk of lung cancer. J Clin Oncol, 2010, 28(16): 2719-2726.
27.	Shiels MS, Katki HA, Hildesheim A, et al. Circulating inflammation markers, risk of lung cancer, and utility for risk stratification. J Natl Cancer Inst, 2015, 107(10): pii: djv199.
28.	Forrest LM, McMillan DC, McArdle CS, et al. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer, 2003, 89(6): 1028-1030.
29.	Jin J, Hu K, Zhou Y, et al. Clinical utility of the modified Glasgow prognostic score in lung cancer: a meta-analysis. PLoS One, 2017, 12(9): e0184412.
30.	Zhu L, Li X, Shen Y, et al. A new prognostic score based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Onco Targets Ther, 2016, 9: 4879-4886.
31.	Pinato DJ, Shiner RJ, Seckl MJ, et al. Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer. Br J Cancer, 2014, 110(8): 1930-1935.
32.	Zhou T, Zhao Y, Zhao S, et al. Comparison of the prognostic value of systemic inflammation response markers in small cell lung cancer patients. J Cancer, 2019, 10(7): 1685-1692.
33.	Leung EY, Scott HR, McMillan DC. Clinical utility of the pretreatment Glasgow prognostic score in patients with advanced inoperable non-small cell lung cancer. J Thorac Oncol, 2012, 7(4): 655-662.
34.	Kishi T, Matsuo Y, Ueki N, et al. Pretreatment modified Glasgow prognostic score predicts clinical outcomes after stereotactic body radiation therapy for early-stage non-small cell lung cancer. Int J Radiat Oncol Biol Phys, 2015, 92(3): 619-626.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet, 2018, 391(10125): 1023-1075.
3. Walker MJ, Zhou C, Backen A, et al. Discovery and validation of predictive biomarkers of survival for non-small cell lung cancer patients undergoing radical radiotherapy: two proteins with predictive value. EBioMedicine, 2015, 2(8): 841-850.
4. Noonan SA, Patil T, Gao D, et al. Baseline and on-treatment characteristics of serum tumor markers in stage Ⅳ oncogene-addicted adenocarcinoma of the lung. J Thorac Oncol, 2018, 13(1): 134-138.
5. Kinoshita T, Ohtsuka T, Yotsukura M, et al. Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stageⅠadenocarcinoma and squamous cell carcinoma of the lung. J Thorac Oncol, 2015, 10(4): 619-628.
6. Holdenrieder S, Wehnl B, Hettwer K, et al. Carcinoembryonic antigen and cytokeratin-19 fragments for assessment of therapy response in non-small cell lung cancer: a systematic review and meta-analysis. Br J Cancer, 2017, 116(8): 1037-1045.
7. Colotta F, Allavena P, Sica A, et al. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinogenesis, 2009, 30(7): 1073-1081.
8. Wisastra R, Dekker FJ. Inflammation, cancer and oxidative lipoxygenase activity are intimately linked. Cancers (Basel), 2014, 6(3): 1500-1521.
9. Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol, 2018, 9: 754.
10. Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial, 2004, 17(6): 432-437.
11. Pastorino U, Morelli D, Leuzzi G, et al. Baseline and postoperative C-reactive protein levels predict long-term survival after lung metastasectomy. Ann Surg Oncol, 2019, 26(3): 869-875.
12. Yang JR, Xu JY, Chen GC, et al. Post-diagnostic C-reactive protein and albumin predict survival in Chinese patients with non-small cell lung cancer: a prospective cohort study. Sci Rep, 2019, 9(1): 8143.
13. McMillan DC, Crozier JE, Canna K, et al. Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis, 2007, 22(8): 881-886.
14. Schoenberg MB, Anger HJW, Hao J, et al. Development of novel biological resection criteria for safe and oncologically satisfying resection of hepatocellular carcinoma. Surg Oncol, 2018, 27(4): 663-673.
15. Walsh SM, Casey S, Kennedy R, et al. Does the modified Glasgow Prognostic Score (mGPS) have a prognostic role in esophageal cancer?. J Surg Oncol, 2016, 113(7): 732-737.
16. Wen J, Bedford M, Begum R, et al. The value of inflammation based prognostic scores in patients undergoing surgical resection for oesophageal and gastric carcinoma. J Surg Oncol, 2018, 117(8): 1697-1707.
17. Cox PR. The Aging of populations and its economic and social implications. Royal Statistical Society, 1958, 121(2): 253-254.
18. Detterbeck FC, Boffa DJ, Kim AW, et al. The eighth edition lung cancer stage classification. Chest, 2017, 151(1): 193-203.
19. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell, 2011, 144(5): 646-674.
20. Balkwill FR, Mantovani A. Cancer-related inflammation: common themes and therapeutic opportunities. Semin Cancer Biol, 2012, 22(1): 33-40.
21. Bromberg J, Wang TC. Inflammation and cancer: IL-6 and STAT3 complete the link. Cancer Cell, 2009, 15(2): 79-80.
22. Ruffell B, Affara NI, Coussens LM. Differential macrophage programming in the tumor microenvironment. Trends Immunol, 2012, 33(3): 119-126.
23. Cannon NA, Meyer J, Iyengar P, et al. Neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic factors after stereotactic radiation therapy for early-stage non-small-cell lung cancer. J Thorac Oncol, 2015, 10(2): 280-285.
24. Kang MH, Go SI, Song HN, et al. The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer, 2014, 111(3): 452-460.
25. Ni XF, Wu J, Ji M, et al. Effect of C-reactive protein/albumin ratio on prognosis in advanced non-small-cell lung cancer. Asia Pac J Clin Oncol, 2018, 14(6): 402-409.
26. Chaturvedi AK, Caporaso NE, Katki HA, et al. C-reactive protein and risk of lung cancer. J Clin Oncol, 2010, 28(16): 2719-2726.
27. Shiels MS, Katki HA, Hildesheim A, et al. Circulating inflammation markers, risk of lung cancer, and utility for risk stratification. J Natl Cancer Inst, 2015, 107(10): pii: djv199.
28. Forrest LM, McMillan DC, McArdle CS, et al. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer, 2003, 89(6): 1028-1030.
29. Jin J, Hu K, Zhou Y, et al. Clinical utility of the modified Glasgow prognostic score in lung cancer: a meta-analysis. PLoS One, 2017, 12(9): e0184412.
30. Zhu L, Li X, Shen Y, et al. A new prognostic score based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Onco Targets Ther, 2016, 9: 4879-4886.
31. Pinato DJ, Shiner RJ, Seckl MJ, et al. Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer. Br J Cancer, 2014, 110(8): 1930-1935.
32. Zhou T, Zhao Y, Zhao S, et al. Comparison of the prognostic value of systemic inflammation response markers in small cell lung cancer patients. J Cancer, 2019, 10(7): 1685-1692.
33. Leung EY, Scott HR, McMillan DC. Clinical utility of the pretreatment Glasgow prognostic score in patients with advanced inoperable non-small cell lung cancer. J Thorac Oncol, 2012, 7(4): 655-662.
34. Kishi T, Matsuo Y, Ueki N, et al. Pretreatment modified Glasgow prognostic score predicts clinical outcomes after stereotactic body radiation therapy for early-stage non-small cell lung cancer. Int J Radiat Oncol Biol Phys, 2015, 92(3): 619-626.

West China Medical Journal

The prognostic value of modified Glasgow Prognostic Score in lung cancer patients

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