Combining information on C reactive protein and serum albumin into the Glasgow Prognostic Score strongly discriminates survival of myelofibrosis patients

2018 ◽  
Vol 72 ◽  
pp. 14-16 ◽  
Author(s):  
Marko Lucijanic ◽  
David Cicic ◽  
Tajana Stoos-Veic ◽  
Vlatko Pejsa ◽  
Dario Rahelic ◽  
...  
Author(s):  
Jiahui Zhou ◽  
Wene Wei ◽  
Hu Hou ◽  
Shufang Ning ◽  
Jilin Li ◽  
...  

Background: Emerging evidence suggests that inflammatory response biomarkers are predictive factors that can improve the accuracy of colorectal cancer (CRC) prognoses. We aimed to evaluate the prognostic significance of C-reactive protein (CRP), the Glasgow Prognostic Score (GPS), and the CRP-to-albumin ratio (CAR) in CRC.Methods: Overall, 307 stage I–III CRC patients and 72 colorectal liver metastases (CRLM) patients were enrolled between October 2013 and September 2019. We investigated the correlation between the pretreatment CRP, GPS, and CAR and the clinicopathological characteristics. The Cox proportional hazards model was used for univariate or multivariate analysis to assess potential prognostic factors. A receiver operating characteristic (ROC) curve was constructed to evaluate the predictive value of each prognostic score. We established CRC survival nomograms based on the prognostic scores of inflammation.Results: The optimal cutoff levels for the CAR for overall survival (OS) in all CRC patients, stage I–III CRC patients, and CRLM patients were 0.16, 0.14, and 0.25, respectively. Kaplan–Meier analysis and log-rank tests demonstrated that patients with high CRP, CAR, and GPS had poorer OS in CRC, both in the cohorts of stage I–III patients and CRLM patients. In the different cohorts of CRC patients, the area under the ROC curve (AUC) of these three markers were all high. Multivariate analysis indicated that the location of the primary tumor, pathological differentiation, and pretreatment carcinoembryonic antigen (CEA), CRP, GPS, and CAR were independent prognostic factors for OS in stage I–III patients and that CRP, GPS, and CAR were independent prognostic factors for OS in CRLM patients. The predictors in the prediction nomograms included the pretreatment CRP, GPS, and CAR.Conclusions: CRP, GPS, and CAR have independent prognostic values in patients with CRC. Furthermore, the survival nomograms based on CRP, GPS, and CAR can provide more valuable clinical significance.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Namiuchi ◽  
S Sunamura ◽  
R Ushigome ◽  
K Noda ◽  
T Takii

Abstract Purpose The Glasgow Prognostic Score (GPS), combination of C-reactive protein (CRP) and serum albumin concentration, provides predictions of prognosis in patients with heart failure. We evaluated the GPS of patients with acute myocardial infarction (MI). Methods We investigated the prognosis of 1182 patients with acute MI in our institution. These patients were classified into three groups by GPS at admission. GPS was defined as follows: patients with both elevated CRP (>1.0mg/dL) and hypoalbuminemia (<3.5 g/dL) were allocated a score of 2, patients with only one of these biochemical abnormalities were allocated a score of 1, and patients with neither of these abnormalities were allocated a score of 0. Results Of the patients, 70.3% (n=831), 19.2% (n=227), and 10.5% (n=124) had GPS of 0, 1, and 2, respectively. In-hospital mortality of GPS 0, GPS 1, and GPS 2 were 4.7%, 18.1%, and 31.5%, respectively (p<0.0001). Relative to a GPS of 0, the hazard ratios for the readmission caused by acute decompensated heart failure (ADHF) were 3.27 (95% CI: 2.04–5.18) for a GPS of 1 and 3.62 (95% CI: 1.93–6.42) for a GPS of 2 in the age- and sex- adjusted Cox proportional hazard model. After propensity score matching, baseline characteristics were balanced, and 250 paired patients constituted GPS 0 group and GPS 1–2 group. Patients with GPS1 or 2 had a higher risk of the development of ADHF compared with patients with GPS 0 (Hazard ratio: 1.96, 95% confidence interval: 1.13–3.47, p=0.017). Conclusions The GPS, which is based on systemic inflammation, is useful for predicting the development of acute decompensated heart failure after myocardial infarction.


2014 ◽  
Vol 99 (5) ◽  
pp. 512-517 ◽  
Author(s):  
Tadahiro Nozoe ◽  
Rumi Matono ◽  
Hideki Ijichi ◽  
Takefumi Ohga ◽  
Takahiro Ezaki

Abstract The Glasgow Prognostic Score (GPS), an inflammation-based score, has been used to predict the biologic behavior of malignant tumors. The aim of the current study was to elucidate a further significance of GPS in colorectal carcinoma. Correlation of GPS and modified GPS (mGPS), which are composed of combined score provided for serum elevation of C-reactive protein and hypoalbuminemia examined before surgical treatment, with clinicopathologic features was investigated in 272 patients with colorectal carcinoma. Survival of GPS 1 patients was significantly worse than that of GPS 0 patients (P= 0.009), and survival of GPS 2 patients was significantly worse than that of GPS 1 patients (P &lt; 0.0001). Similarly, survival of mGPS 1 patients was significantly worse than that of mGPS 0 patients (P = 0.009), and survival of mGPS 2 patients was significantly worse than that of mGPS 1 patients (P = 0.0006). Multivariate analysis demonstrated that GPS (P &lt; 0.0001) as well as tumor stage (P= 0.004) and venous invasion (P = 0.011) were factors independently associated with worse prognosis. Both GPS and mGPS could classify outcome of patients with a clear stratification, and could be applied as prognostic indicators in colorectal carcinoma.


Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 139 ◽  
Author(s):  
Servet Altay ◽  
Muhammet Gürdoğan ◽  
Muhammed Keskin ◽  
Fatih Kardaş ◽  
Burcu Çakır

Background: The Glasgow prognostic score (GPS), which is obtained from a combination of C-reactive protein (CRP) and serum albumin level, predicts poor prognoses in many cancer types. Systemic inflammation also plays an important role in pathogenesis of cardiovascular diseases. In this study, we aimed to investigate the effect of inflammation-based GPS on in-hospital and long-term outcomes in patients hospitalized in intensive cardiovascular care unit (ICCU). Methods: A total of 1004 consecutive patients admitted to ICCU were included in the study, and patients were divided into three groups based on albumin and CRP values as GPS 0, 1, and 2. Patients’ demographic, clinic, and laboratory findings were recorded. In-hospital and one-year mortality rates were compared between groups. Results: Mortality occurred in 109 (10.8%) patients in in-hospital period, 82 (8.1%) patients during follow-up period, and thus, cumulative mortality occurred in 191 (19.0%) patients. Patients with a high GPS score had a higher rate of comorbidities and represented increased inflammatory evidence. In the multivariate regression model there was independent association with in-hospital mortality in GPS 1 patients compared to GPS 0 patients (Odds ratio, (OR); 5.52, 95% CI: 1.2–16.91, p = 0.025) and in GPS 2 patients compared to GPS 0 patients (OR; 7.01, 95% CI: 1.39–35.15, p = 0.018). A higher GPS score was also associated with a prolonged ICCU and hospital stay, and increased re-hospitalization in the follow-up period. Conclusion: Inflammation based GPS is a practical tool in the prediction of worse prognosis both in in-hospital and one-year follow-up periods in ICCU patients.


Cancers ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 514 ◽  
Author(s):  
Ichikawa ◽  
Mizuno ◽  
Hayasaki ◽  
Kishiwada ◽  
Fujii ◽  
...  

Background: In many malignancies, including pancreatic ductal adenocarcinoma (PDAC), host-related inflammatory/immunonutritional markers, such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and C-reactive protein (CRP)/albumin ratio are reported to be prognostic factors. However, the prognostic influence of these factors before and after chemoradiotherapy (CRT) has not been studied in PDAC patients. Methods: Of 261 consecutive PDAC patients who were scheduled for CRT with gemcitabine or S1 plus gemcitabine between February 2005 and December 2015, participants in this study were 176 who completed CRT and had full data available on inflammatory/immunonutritional markers as well as on anatomical and biological factors for the investigation of prognostic/predictive factors. Results: In multivariate analysis, the significant prognostic factors were RECIST classification, cT category, performance status, post-CRT carcinoembryonic antigen, post-CRT C-reactive protein/albumin ratio, post-CRT mGPS, and post-CRT PNI. Post-CRT PNI (cut-off value, 39) was the strongest host-related prognostic factor according to the p-value. In the patients who underwent resection after CRT, median survival time (MST) was significantly shorter in the 12 patients with low PNI (<39) than in the 97 with high PNI (≥39), at 15.5 months versus 27.2 months, respectively (p = 0.0016). In the patients who did not undergo resection, MST was only 8.9 months in those with low PNI and 12.3 months in those with high PNI (p < 0.0001), and thus was similar to that of the resected patients with low PNI. Conclusions: Post-CRT PNI was the strongest prognostic/predictive indicator among the independent biological and conditional prognostic factors in PDAC patients who underwent CRT.


2020 ◽  
Author(s):  
Yoshihiro Araki ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
Shinji Miwa ◽  
...  

Abstract Background: Systemic inflammation responses have been associated with cancer development, progression and metastasis. However, little is known about the risk of metastasis based on inflammatory-based scores in patients with osteosarcoma before treatment. We therefore estimated the predictive value of these parameters for metastasis in osteosarcoma.Methods: A total of 54 osteosarcoma patients were enrolled in this retrospective study. All had been diagnosed histologically, and their laboratory data at the first visit were collected from medical records. The lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), monocyte-neutrophil ratio (MNR), platelet-lymphocyte ratio (PLR), Glasgow prognostic score (GPS), neutrophil-platelet score (NPS), neutrophil counts (NC), lymphocyte counts (LC), monocyte counts (MC), and C-reactive protein (CRP) were evaluated.Results: High values of CRP, PLR, MNR, and NPS and a low NC were significantly associated with metastasis of osteosarcoma patients in the univariate analysis. A multivariate Cox regression analysis revealed that a high CRP level (>0.6mg/dL) (hazard ratio=9.7, 95% confidence interval=3.0-31 ; p=0.00010) and low NC (<4087/µL) (hazard ratio=0.13, 95% confidence interval =0.040-0.42 ; p=0.00080) were risk factors significantly associated with metastasis of osteosarcoma patients.Conclusions: Our study demonstrated that the combination of a high CRP level and low NC before treatment was a useful inflammatory-based prognostic indicator for metastasis in patients with osteosarcoma.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11084-11084
Author(s):  
M. Ishizuka ◽  
H. Nagata ◽  
K. Takagi ◽  
K. Kubota

11084 Background: Recent studies have revealed that the Glasgow prognostic score (GPS), an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the GPS in patients undergoing chemotherapy for far advanced or recurrent unresectable colorectal cancer (AR-UCRC). Objective: To demonstrate the influence of the GPS for prognostication of patients undergoing chemotherapy for AR-UCRC. Methods: The GPS was calculated as follows: patients with both an elevated level of CRP (>1.0 mg/dl) and hypoalbuminemia (<3.5 g/dl) were allocated a score of 2, and patients showing one or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. Results: One hundred twelve patients who had undergone chemotherapy for AR-UCRC with regimens such as such as FOLFIRI (5-fluorouracil [5-FU]/l-leucovorin [LV]/irinotecan hydrochloride [CPT-11]) or FOLFOX (5-FU/LV/oxialiplatin [L-OHP]) were evaluated retrospectively. Kaplan-Meier analysis and log rank test revealed that GPS2 predicted a higher risk of mortality than GPS0 or 1 (P <0.0001). Univariate analyses revealed that the neutrophil ratio (P = 0.0411), CA19–9 (P = 0.0473), CRP (P = 0.0477), albumin (P = 0.0043) and GPS (0,1/2) (P < 0.0001) were associated with mortality. Multivariate analyses using these five factors revealed that only GPS (0,1/2) (odds ratio, 6.071; 95% C.I., 1.625–22.68; P = 0.0073) was an independent risk factor of mortality. Conclusions: GPS is considered the most important and independent predictor of mortality in patients undergoing chemotherapy for AR-UCRC. No significant financial relationships to disclose.


Author(s):  
Nuttaradee Lojanapiwat ◽  
Md Rafiqul Islam ◽  
Martin Ridout ◽  
Sivakumar Subramaniam

Background: Accurate prognostication is essential in caring for palliative patients. Various prognostication tools have been validated in many settings in the past few years. Biomarkers of inflammation (albumin and C-reactive protein) are combined to calculate the modified Glasgow prognostic score (mGPS), which has been found to be a simple prognostic tool in this population. Objective: This retrospective cohort study was to evaluate mGPS as a prognostication tool for cancer patients admitted to an acute hospital in regional Australia. Methods: Adult cancer patients admitted to an acute Australian regional hospital during 2017 who had albumin and C-reactive protein (CRP) tested were included. The mGPS was calculated based on their admission values and discharge values. Based on their score (0-2), groups were compared using univariate and multivariate Cox regression analysis for prognostication. Kaplan-Meier survival plots and median survival time from admission and discharge were constructed. Results: A total of 170 patient records were reviewed of which 95 had admission and discharge mGPS scores available for analysis. Of those, 86 had died at the time of data analysis. The median survival for admission mGPS 0, 1, 2 was 168,156 and 74 days. For discharge mGPS 0, 1, 2 medians were 168,119 and 70 days. On multi variate analysis admission mGPS 2 showed Hazard ratio of 2.29 (95% CI 1.16-4.56, p -0.02) and discharge mGPS 2 of 2.07 (95% CI 0.95-4.50, p value 0.07). Conclusions: In this study, mGPS was able to differentiate cancer patients into various prognostic groups. Further studies in regional acute hospitals could validate this prospectively with a multi-center larger sample size.


Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 859
Author(s):  
Woosung Son ◽  
Su-Jin Shin ◽  
Su Hyeong Park ◽  
Soo Kyung Lee ◽  
Eun Jung Park ◽  
...  

The prognostic impact of the combination of the modified Glasgow prognostic score (mGPS) and C-reactive protein/albumin ratio (CAR) in colorectal cancer (CRC) is unclear. We aimed to investigate the clinical usefulness of this combination as a predictor of survival in CRC patients. We retrospectively evaluated 769 CRC patients who had undergone surgery between January 2006 and March 2014. The CAR and mGPS within 1 month postoperation were examined. The integrated area under the curve (iAUC) was compared among mGPS, CAR, and the combined classification (CC). The optimal CAR cut-off for discriminating overall survival was 0.14. Based on this cut-off, the mGPS 0 group was divided into the mGPS 0 with low CAR and the mGPS 0 with high CAR groups, whereas all mGPS 1 and 2 patients were classified into the high CAR group. CC was an independent prognostic factor, and its iAUC value (0.587, 95% CI 0.553–0.624) was superior to those of the mGPS (0.544, 95% CI 0.516–0.576) (bootstrap iAUC mean difference = 0.043; 95% CI = 0.015–0.072) and CAR (0.578, 95% CI 0.545–0.613) (bootstrap iAUC mean difference = 0.009; 95% CI = 0.002–0.017), respectively. In conclusion, the combination of mGPS and CAR has a synergistic effect and has a higher prognostic accuracy than mGPS or CAR alone in patients with CRC.


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