scholarly journals 972 Investigating the Modified Glasgow Prognostic Score as A Tool in Patients Undergoing Surgery for Sarcoma - A Newcastle Cohort Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Chan ◽  
K Rankin
Keyword(s):  
Soft Tissue ◽  
Statistical Significance ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Oncological Outcome ◽  
Soft Tissue Tumour ◽  
Clinical Notes ◽  
The North ◽  
Modified Glasgow Prognostic Score ◽  
Tissue Tumour

Abstract Aim Sarcomas are an aggressive group of cancers with a poor prognosis. The modified Glasgow Prognostic Score (mGPS) uses CRP and albumin levels to generate a score from 0 to 2. A higher mGPS is associated with worse outcomes and is validated in various carcinomas. However, less evidence exists for its usefulness in sarcoma and this study aims to further investigate this area. Method All patients with a bone or soft tissue sarcoma diagnosis presenting to the North of England Bone and Soft Tissue Tumour Service between 2010 – 2014 were analysed. A retrospective review of clinical notes, pre-operative biochemistry results and oncological outcome was performed. Primary outcome measures were local recurrence or metastasis and overall survival (OS). Results 80 patients met the inclusion criteria (28 females and 52 males). 64% of patients were aged >50 at diagnosis. 78% of tumours were high grade (Trojani Grade 2/3) and 71% were >5cm in size. 51 patients had a calculated mGPS=0, 19 patients had mGPS=1 and 10 patients had mGPS=2. In the mGPS=0 group, 22% developed recurrence or metastases and median OS was 42.2 months. For an mGPS of 1 and 2, the rate of recurrence or metastasis was 58% and 60% respectively, and median OS was 41.6 and 39.9 months. Conclusions Pre-surgical CRP and albumin levels (mGPS) may be important in predicting outcome and aiding the management of sarcoma patients. In this cohort, a higher mGPS (1/2) was associated with increased frequency of recurrence or metastasis, however further data is required to determine statistical significance.

scholarly journals Sarcomas in the groin and inguinal canal – often missed and difficult to manage

2010 ◽  
Vol 92 (4) ◽  
pp. 326-329 ◽  
Author(s):  
T Collin ◽  
AV Blackburn ◽  
RH Milner ◽  
C Gerrand ◽  
M Ragbir
Keyword(s):  
Soft Tissue ◽  
Clinical Excellence ◽  
Distant Metastases ◽  
Outcome Data ◽  
Surgical Reconstruction ◽  
Soft Tissue Tumour ◽  
Retrospective Case ◽  
The North ◽  
Tissue Tumour ◽  
Unplanned Excision

INTRODUCTION This is a 7-year retrospective review summarising the North of England Bone and Soft Tissue Tumour Service's experience of managing 13 cases of groin sarcoma requiring soft tissue flap reconstruction. This study was performed to try to identify where national referral guidelines in sarcoma management had been followed and reasons for any delays. The study also includes outcome data relating to these patients. PATIENTS AND METHODS A retrospective, case-note review was undertaken using the local sarcoma database to identify approriate patients. RESULTS In nine patients, national referral guidelines were not followed. This resulted in a mean delay of presentation to the multidisciplinary team of 4.4 months. Ten patients had unplanned excision or exploration of tumours before referral. There were no lower limb amputations. All patients with narrow margins or high grade tumours were referred for radiotherapy. Four patients died; three as a result of distant metastases and one as a result of local recurrence. CONCLUSIONS Despite delays in referral, treatment by wide excision and plastic surgical reconstruction allowed for local control of these tumours with functional limb salvage. Implementation of National Institute for Health and Clinical Excellence (NICE) guidelines and local strategies could improve the expedient management of these patients.

Does the modified Glasgow Prognostic Score aid in the management of patients undergoing surgery for a soft-tissue sarcoma?

2022 ◽  
Vol 104-B (1) ◽  
pp. 168-176
Author(s):  
◽  
Stephanie Spence ◽  
James Doonan ◽  
Omer M. Farhan-Alanie ◽  
Corey D. Chan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Clinical Decision Making ◽  
Tumour Size ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Modified Glasgow Prognostic Score ◽  
Clinical Databases

Aims The modified Glasgow Prognostic Score (mGPS) uses preoperative CRP and albumin to calculate a score from 0 to 2 (2 being associated with poor outcomes). mGPS is validated in multiple carcinomas. To date, its use in soft-tissue sarcoma (STS) is limited, with only small cohorts reporting that increased mGPS scores correlates with decreased survival in STS patients. Methods This retrospective multicentre cohort study identified 493 STS patients using clinical databases from six collaborating hospitals in three countries. Centres performed a retrospective data collection for patient demographics, preoperative blood results (CRP and albumin levels and neutrophil, leucocyte, and platelets counts), and oncological outcomes (disease-free survival, local, or metastatic recurrence) with a minimum of two years' follow-up. Results We found that increased mGPS, tumour size, grade, neutrophil/lymphocyte ratio, and disease recurrence were associated with reduced survival. Importantly, mGPS was the best at stratifying prognosis and could be used in conjunction with tumour grade to sub-stratify patient survival. Conclusion This study demonstrated that prognosis of localized STS strongly correlates with mGPS, as an increasing score is associated with a poorer outcome. We note that 203 patients (41%) with an STS have evidence of systemic inflammation. We recommend the mGPS and other biochemical blood indicators be introduced into the routine diagnostic assessment in STS patients to stratify patient prognosis. Its use will support clinical decision-making, especially when morbid treatment options such as amputation are being considered. Cite this article: Bone Joint J 2022;104-B(1):168–176.

scholarly journals The Effectiveness of “Two-Week” Referrals for Suspected Bone and Soft Tissue Sarcoma

Sarcoma ◽  
2007 ◽  
Vol 2007 ◽  
pp. 1-3 ◽  
Author(s):  
A. Malik ◽  
L. Wigney ◽  
S. Murray ◽  
C. H. Gerrand
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
General Practitioners ◽  
Diagnosis And Treatment ◽  
Soft Tissue Tumour ◽  
Malignant Tumours ◽  
Urgent Referral ◽  
The North ◽  
Tissue Tumour ◽  
Time To Diagnosis

The two-week “wait” target introduced in 2000 requires that patients with suspected cancer referred by general practitioners should be seen within two weeks. We reviewed patients who had been referred under this standard to the North of England Bone and Soft Tissue Tumour Service, to determine if the referral guidelines had been followed, and what proportion of patients referred under the guideline had malignant tumours. 40 patients were referred under the guideline between January 2004 and December 2005. Ten of these patients (2548%) had malignant tumours, compared with 243 of 507 (48%) of those referred from other sources. In 9 of the 40 cases, the patient did not meet the criteria for urgent referral. Although this target has focussed attention on shortening the time to diagnosis and treatment, prioritising patients referred from general practitioners has the potential to disadvantage those with malignant tumours referred from other sources.

Experience of angiosarcoma in the North of England Bone and Soft Tissue Tumour Service

2011 ◽  
Vol 64 (7) ◽  
pp. 884-891 ◽  
Author(s):  
C.J. Lewis ◽  
C. Gerrand ◽  
D.E. Barnes ◽  
S. Murray ◽  
R.H. Milner ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Tumour ◽  
The North ◽  
Tissue Tumour

scholarly journals Modified Glasgow Prognostic Score associated with survival in metastatic renal cell carcinoma treated with immune checkpoint inhibitors

2021 ◽  
Vol 9 (7) ◽  
pp. e002851
Author(s):  
Jacqueline T Brown ◽  
Yuan Liu ◽  
Julie M Shabto ◽  
Dylan Martini ◽  
Deepak Ravindranathan ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Immune Checkpoint ◽  
Renal Cell ◽  
Checkpoint Inhibitors ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Glasgow Prognostic Score ◽  
Modified Glasgow Prognostic Score

BackgroundThe modified Glasgow Prognostic Score (mGPS) is a composite biomarker that uses albumin and C reactive protein (CRP). There are multiple immune checkpoint inhibitor (ICI)-based combinations approved for metastatic renal cell carcinoma (mRCC). We investigated the ability of mGPS to predict outcomes in patients with mRCC receiving ICI.MethodsWe retrospectively reviewed patients with mRCC treated with ICI as monotherapy or in combination at Winship Cancer Institute between 2015 and 2020. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of ICI until death or clinical/radiographical progression, respectively. The baseline mGPS was defined as a summary score based on pre-ICI values with one point given for CRP>10 mg/L and/or albumin<3.5 g/dL, resulting in possible scores of 0, 1 and 2. If only albumin was low with a normal CRP, no points were awarded. Univariate analysis (UVA) and multivariate analysis (MVA) were carried out using Cox proportional hazard model. Outcomes were also assessed by Kaplan-Meier analysis.Results156 patients were included with a median follow-up 24.2 months. The median age was 64 years and 78% had clear cell histology. Baseline mGPS was 0 in 36%, 1 in 40% and 2 in 24% of patients. In UVA, a baseline mGPS of 2 was associated with shorter OS (HR 4.29, 95% CI 2.24 to 8.24, p<0.001) and PFS (HR 1.90, 95% CI 1.20 to 3.01, p=0.006) relative to a score of 0; this disparity in outcome based on baseline mGPS persisted in MVA. The respective median OS of patients with baseline mGPS of 0, 1 and 2 was 44.5 (95% CI 27.3 to not evaluable), 15.3 (95% CI 11.0 to 24.2) and 10 (95% CI 4.6 to 17.5) months (p<0.0001). The median PFS of these three cohorts was 6.7 (95% CI 3.6 to 13.1), 4.2 (95% CI 2.9 to 6.2) and 2.6 (95% CI 2.0 to 5.6), respectively (p=0.0216). The discrimination power of baseline mGPS to predict survival outcomes was comparable to the IMDC risk score based on Uno’s c-statistic (OS: 0.6312 vs 0.6102, PFS: 0.5752 vs 0.5533).ConclusionThe mGPS is prognostic in this cohort of patients with mRCC treated with ICI as monotherapy or in combination. These results warrant external and prospective validation.

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