A Survey of Attitudes towards the Clinical Application of Systemic Inflammation Based Prognostic Scores in Cancer

Introduction.The systemic inflammatory response (SIR) plays a key role in determining nutritional status and survival of patients with cancer. A number of objective scoring systems have been shown to have prognostic value; however, their application in routine clinical practice is not clear. The aim of the present survey was to examine the range of opinions internationally on the routine use of these scoring systems.Methods.An online survey was distributed to a target group consisting of individuals worldwide who have reported an interest in systemic inflammation in patients with cancer.Results.Of those invited by the survey (n=238), 65% routinely measured the SIR, mainly for research and prognostication purposes and clinically for allocation of adjuvant therapy or palliative chemotherapy. 40% reported that they currently used the Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/mGPS) and 81% reported that a measure of systemic inflammation should be incorporated into clinical guidelines, such as the definition of cachexia.Conclusions.The majority of respondents routinely measured the SIR in patients with cancer, mainly using the GPS/mGPS for research and prognostication purposes. The majority reported that a measure of the SIR should be adopted into clinical guidelines.

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Interrelation between ofsystemic inflammation factors and cardiovascular calcification factors in patients of chronic kidney disease 5D stage

Nephrology (Saint-Petersburg) ◽

10.36485/1561-6274-2020-24-5-58-63 ◽

2020 ◽

Vol 24 (5) ◽

pp. 58-63

Author(s):

A. M. Mambetova ◽

M. H. Hutueva ◽

I. K. Thabisimova ◽

A. S. Kegaduyev

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Systemic Inflammation ◽

Heart Valves ◽

Prognostic Score ◽

Risk Index ◽

Glasgow Prognostic Score ◽

Probability Of Detection ◽

Blood Concentrations ◽

The Glasgow Prognostic Score

BACKGROUND. The role of inflammation and uremic intoxication in the development and progression of bone mineral disorders, including cardiovascular calcification, has been actively studied over the past decades. PATIENTS AND METHODS. A single-stage, cohort study of 85 patients with stage 5D CKD treated with programmatic hemodialysis was conducted. The blood concentrations of interleukin-3 (IL-3) and interleukin-6 (IL-6) were determined using the enzyme immunoassay, the level of fibrinogen - using the Rutberg method, and the level of p2-microglobulins - using the nephelometric method. The blood leukocyte shift index (ISLC) and the Glasgow Prognostic Score (GPS) risk index for systemic inflammation were also calculated, taking into account the level of C-reactive protein (CRP) and blood albumin. The presence of valvular calcification, its severity, and calcification of the abdominal aortic wall was recorded. Statistical analysis was performed using the program STATISTICA 12.6 ("StatSoft", USA). THE AIM: to evaluate the relationship between factors of systemic inflammation and cardiovascular calcification in patients with stage 5D chronic kidney disease. RESULTS. The risk of detecting calcification of the aorta and heart valves was influenced by the pro-inflammatory cytokines IL-3 and IL-6, as well as ISLK and GPS. However, inflammatory factors such as fibrinogen, p2-microglobulin, and CRP levels in the blood did not show a statistically significant effect. In the case when the predicted parameter was chosen not friendly calcification, but the presence of any of its components, the predictive significance of IL-3 decreased, but IL-6 remained. The 20% risk threshold was exceeded at IL-6 values of more than 33 pg/ml. The effect of ISLC on the probability of detection of calcification was shown both about friendly calcification and concerning isolated calcification of the aorta or valves. CONCLUSION. It was found that among the studied factors of inflammation, IL-6, ILK, and IL-3 demonstrate a relationship with the processes of cardiovascular calcification, GPS-only in relation to friendly calcification. Nomograms have been developed that allow predicting the detection of cardiovascular calcification in dialysis patients, depending on the state of the inflammatory circuit.

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Systemic pro-inflammatory response identifies patients with cancer with adverse outcomes from SARS-CoV-2 infection: the OnCovid Inflammatory Score

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-002277 ◽

2021 ◽

Vol 9 (3) ◽

pp. e002277 ◽

Cited By ~ 1

Author(s):

Gino M Dettorre ◽

Saoirse Dolly ◽

Angela Loizidou ◽

John Chester ◽

Amanda Jackson ◽

...

Keyword(s):

Inflammatory Response ◽

Cancer Progression ◽

Systemic Inflammation ◽

Prognostic Score ◽

Prognostic Index ◽

Glasgow Prognostic Score ◽

Prognostic Nutritional Index ◽

Adverse Outcomes ◽

Patients With Cancer ◽

Inflammatory Score

BackgroundPatients with cancer are particularly susceptible to SARS-CoV-2 infection. The systemic inflammatory response is a pathogenic mechanism shared by cancer progression and COVID-19. We investigated systemic inflammation as a driver of severity and mortality from COVID-19, evaluating the prognostic role of commonly used inflammatory indices in SARS-CoV-2-infected patients with cancer accrued to the OnCovid study.MethodsIn a multicenter cohort of SARS-CoV-2-infected patients with cancer in Europe, we evaluated dynamic changes in neutrophil:lymphocyte ratio (NLR); platelet:lymphocyte ratio (PLR); Prognostic Nutritional Index (PNI), renamed the OnCovid Inflammatory Score (OIS); modified Glasgow Prognostic Score (mGPS); and Prognostic Index (PI) in relation to oncological and COVID-19 infection features, testing their prognostic potential in independent training (n=529) and validation (n=542) sets.ResultsWe evaluated 1071 eligible patients, of which 625 (58.3%) were men, and 420 were patients with malignancy in advanced stage (39.2%), most commonly genitourinary (n=216, 20.2%). 844 (78.8%) had ≥1 comorbidity and 754 (70.4%) had ≥1 COVID-19 complication. NLR, OIS, and mGPS worsened at COVID-19 diagnosis compared with pre-COVID-19 measurement (p<0.01), recovering in survivors to pre-COVID-19 levels. Patients in poorer risk categories for each index except the PLR exhibited higher mortality rates (p<0.001) and shorter median overall survival in the training and validation sets (p<0.01). Multivariable analyses revealed the OIS to be most independently predictive of survival (validation set HR 2.48, 95% CI 1.47 to 4.20, p=0.001; adjusted concordance index score 0.611).ConclusionsSystemic inflammation is a validated prognostic domain in SARS-CoV-2-infected patients with cancer and can be used as a bedside predictor of adverse outcome. Lymphocytopenia and hypoalbuminemia as computed by the OIS are independently predictive of severe COVID-19, supporting their use for risk stratification. Reversal of the COVID-19-induced proinflammatory state is a putative therapeutic strategy in patients with cancer.

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The prevalence of cancer associated systemic inflammation: Implications of prognostic studies using the Glasgow Prognostic Score

Critical Reviews in Oncology/Hematology ◽

10.1016/j.critrevonc.2020.102962 ◽

2020 ◽

Vol 150 ◽

pp. 102962 ◽

Cited By ~ 1

Author(s):

Ross D. Dolan ◽

Donald C. McMillan

Keyword(s):

Systemic Inflammation ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

The Glasgow Prognostic Score ◽

Prevalence Of Cancer

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Prognostic value of the systemic inflammation modified Glasgow Prognostic Score in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy: Results from a large multicenter international collaboration

European Urology Supplements ◽

10.1016/s1569-9056(19)30715-8 ◽

2019 ◽

Vol 18 (1) ◽

pp. e982-e983

Author(s):

F. Soria ◽

D. D’Andrea ◽

J.A. Karam ◽

C.G. Wood ◽

M. Rouprêt ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Systemic Inflammation ◽

International Collaboration ◽

Prognostic Value ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Upper Tract Urothelial Carcinoma ◽

Radical Nephroureterectomy ◽

Upper Tract ◽

Modified Glasgow Prognostic Score

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Comorbidity and systemic inflammation are independent prognostic factors in patients with colorectal cancer: A ScotScan collaborative study.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.707 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 707-707

Author(s):

James Hugh Park ◽

Anniken Fuglestad ◽

Anne Helene Kostner ◽

Antonia K. Roseweir ◽

Joanne Edwards ◽

...

Keyword(s):

Colorectal Cancer ◽

Systemic Inflammation ◽

Inflammatory Responses ◽

Prognostic Score ◽

Collaborative Study ◽

Glasgow Prognostic Score ◽

Clinicopathological Characteristics ◽

Stage Ii ◽

Royal Infirmary ◽

Modified Glasgow Prognostic Score

707 Background: Although inextricably linked, both comorbidity and systemic inflammatory responses have been shown to determine survival in patients undergoing surgery for colorectal cancer (CRC). The present study examines the interrelationships between comorbidity (ASA grade) and systemic inflammation (modified Glasgow Prognostic Score (mGPS)) in patients from the ScotScan dataset. Methods: Clinicopathological characteristics and outcome of consecutive patients undergoing potentially curative resection of TNM I-III CRC in Glasgow Royal Infirmary (Scotland) and Sørlandet Hospital (Norway) were prospectively collected. ASA grade and mGPS (0-CRP ≤ 10mg/L, 1-CRP > 10mg/L, 2-CRP > 10mg/L and albumin < 35g/L) prior to surgery was recorded and relationship with overall survival (OS) examined. Results: 2,295 patients (Scotland: n = 1,234 , Norway: n = 1,061) were included. Patients from Norway were more likely to be older, female and have higher ASA grade (all P < 0.001), and more likely to have colon cancer (76% vs. 67%, P < 0.001). Patients from Norway were less likely to be systemically inflamed (mGPS = 0: 72% vs. 65%, P < 0.001), even after propensity score matching ( n = 736, OR 0.36 95%CI0.25-0.51, P < 0.001). ASA grade and mGPS were significantly associated; 21% of ASA 1 patients had mGPS ≥ 1 compared to 41% of ASA four patients ( P < 0.001). In the propensity-matched cohort, both increasing ASA (HR 1.98 95% CI1.57-2.49, P < 0.001) and mGPS (HR 1.20 95% CI1.02-1.41, P = 0.027) were associated with OS independent of age, N stage and adjuvant therapy use; results in the whole cohort were similar. The combination of ASA grade and mGPS was examined with respect to OS in patients with stage II-III CRC (Table 1). In patients with stage II disease, 3-year OS was stratified from 96% (ASA 1, mGPS0) to 67% (ASA 3, mGPS2) ( P < 0.001); in patients with stage II disease, 3-year OS was stratified from 84% to 44% ( P < 0.001). Conclusions: Using a large, prospectively collected dataset of patients undergoing resection of CRC in two countries, the results of the present study confirm the independent prognostic value of measures of comorbidity and systemic inflammation prior to surgery.

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