Prognostic value of routine biomarkers in older patients with cancer: Pooled analysis of three prospective cohorts.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11551-11551
Author(s):  
Elena Paillaud ◽  
Pierre Soubeyran ◽  
Nadia Oubaya ◽  
Etienne Brain ◽  
Marianne Fonck ◽  
...  

11551 Background: To assess prognostic value of routine biomarkers in older patients with cancer. Methods: A pooled analysis of three prospective multicentre cohorts, ELCAPA, PHRC Aquitaine and ONCODAGE was conducted. Patients aged 70 years or older, with cancer were included. Biomarkers collected were plasmatic C-reactive protein, albumin and a combined score: Glasgow Prognostic Score (GPS). The GPS comprised three categories (0: CRP≤10 mg/L, albumin≥35 g/L; 1: CRP≤10 mg/L and albumin < 35 g/L, or CRP > 10 mg/L and albumin≥35 g/L; 2: CRP > 10 mg/L and albumin < 35 g/L).The primary endpoint was overall survival at 12 months. Multivariable Cox models were used, adjusting for age, sex, localisation, metastatic status, performance status, frailty screening index, the G8. Discriminative properties were assessed using Harrell C index and NRI (Net Reclassification Improvement). Results: Overall 1800 patients were analyzed (ELCAPA: N = 543, PHRC Aquitaine: N = 253, ONCODAGE: N = 1004; mean age: 78.5±5.5 years; 61.7% of men; 37% metastatic; most frequent localisations: breast (34.9%) and colon-rectum (17.7%); 70.7% of patients screened at risk of frailty with G8). Overall survival was 71.1%. GPS was independently associated with death (among normal G8: GPS 1: Hazard Ratio (HR) = 4.48; 95% Confidence Interval (95% CI) = [2.03; 9.89], GPS 2: 11.64 [4.54; 29.81], among abnormal G8: GPS 1: 2.45 [1.79; 3.34], GPS 2: 3.97 [2.93; 5.37]. The addition of GPS to the clinical model (Harell C: 0.82 [0.80; 0.83]) improved discrimination (Harell C: 0.84 [0.82; 0.85], NRI: 11% [5; 19]). Conclusions: GPS could be used in older patients with cancer to help decision-making and prognosis assessment.

2020 ◽  
Vol 35 (3) ◽  
pp. 3-13 ◽  
Author(s):  
Xingxia Zhang ◽  
Jie Yang ◽  
Liang Du ◽  
Yong Zhou ◽  
Ka Li

Objectives: Over the past decade, some publications have reported that Immunoscore was associated with the prognosis of several cancers. To better understand this issue, we conducted this pooled analysis. Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from their inceptions to 15 May 2019 to identify relevant articles. The pooled hazard ratio (HR) and 95% confidence interval (CI) was estimated for overall survival, disease-free survival, and disease-specific survival. Results: A total of 26 cohort studies with 10,328 patients involving eight cancer specialties were evaluated mainly by the consensus Immunoscore. The pooled analysis indicated that a lower Immunoscore was associated with a poor overall survival (HR 2.23, 95% CI 1.58, 2.70), disease-free survival (HR 2.40, 95% CI 1.96, 2.49), and disease-specific survival (HR 2.81, 95% CI 2.10, 3.77) for all cancers. The same convincing results were found in colorectal cancer, gastric cancer, and non-small cell lung cancer (especially the consensus Immunoscore for colon cancer). In five other types of cancer the results were similar, but the sample sizes were limited. Conclusions: These findings support that Immunoscore is significantly associated with the prognosis of patients with cancer. It provides a reliable estimate of the risk of recurrence in patients with colon cancer. However, more high-quality studies are necessary to assess the prognostic value of Immunoscore in non-colon cancers.


2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Xiaotong Song ◽  
Hao Zhang ◽  
Fanxing Yin ◽  
Panpan Guo ◽  
Xiaocheng Yang ◽  
...  

Background. Inflammatory markers are associated with tumor genesis and progression, but their prognostic significance in osteosarcoma remains unclear. Therefore, we discussed the prognostic value of related inflammatory markers in osteosarcoma through a meta-analysis and systematic review. These inflammatory markers include C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), and Glasgow prognostic score (GPS). Methods. The Chinese National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journals (VIP), PubMed, Embase, and Cochrane libraries were searched. The design of meta-analysis was made based on the PICOS (population, intervention/exposure, control, outcomes, and study design) principles, and STATA 15.1 was used to analyze the data. The Newcastle-Ottawa scale (NOS) was used to assess the quality of included studies. Hazard ratios (HRs) for overall survival (OS) and disease-specific survival (DPS) were extracted for the investigation of the prognostic value of inflammatory markers. Results. Twelve researches with 2162 osteosarcoma patients were included in total. The pooled results showed that elevated NLR, CRP, and GPS are all greatly related to shortening of OS among patients with osteosarcoma ( HR = 1.68 , P = 0.007 , 95% CI: 1.15-2.45; HR = 1.96 , P = 0.002 , 95% CI: 1.28-3.00; HR = 2.54 , P < 0.0001 , 95% CI: 1.95-3.31, respectively), and CRP level is significantly associated with shortening of DPS among patients with osteosarcoma ( HR = 2.76 , 95% CI:2.01-3.80, P < 0.0001 ), additionally. However, the correlation between LMR or PLR and the prognosis of osteosarcoma is not statistically significant ( HR = 0.60 , 95% CI: 0.30-1.18, P = 0.138 ; HR = 1.13 , 95% CI: 0.85-1.49, P = 0.405 , respectively). The outcomes of subgroup analysis to NLR and CRP suggested that histology, ethnicity, metastasis, and sample size all have an impact on its prognosis of patients with osteosarcoma. Conclusion. Worsened prognosis may be related to high levels of NLR, CRP, and GPS before treatment rather than LMR or PLR, which can provide the basis for clinicians to judge the outcomes of prognosis. Trial Registration. PROSPERO (CRD42021249954), https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=249954.


Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6154
Author(s):  
Nadia Oubaya ◽  
Pierre Soubeyran ◽  
Nicoleta Reinald ◽  
Marianne Fonck ◽  
Mylène Allain ◽  
...  

Background: The prognostic assessment of older cancer patients is complicated by their heterogeneity. We aimed to assess the prognostic value of routine inflammatory biomarkers. Methods: A pooled analysis of prospective multicenter cohorts of cancer patients aged ≥70 was performed. We measured CRP and albumin, and calculated Glasgow Prognostic Score (GPS) and CRP/albumin ratio. The GPS has three levels (0 = CRP ≤ 10 mg/L, albumin ≥ 35 g/L, i.e., normal values; 1 = one abnormal value; 2 = two abnormal values). One-year mortality was assessed using Cox models. Discriminative power was assessed using Harrell’s C index (C) and net reclassification improvement (NRI). Results: Overall, 1800 patients were analyzed (mean age: 79 ± 6; males: 62%; metastases: 38%). The GPS and CRP/albumin ratio were independently associated with mortality in patients not at risk of frailty (hazard ratio [95% confidence interval] = 4.48 [2.03–9.89] for GPS1, 11.64 [4.54–29.81] for GPS2, and 7.15 [3.22–15.90] for CRP/albumin ratio > 0.215) and in patients at risk of frailty (2.45 [1.79–3.34] for GPS1, 3.97 [2.93–5.37] for GPS2, and 2.81 [2.17–3.65] for CRP/albumin ratio > 0.215). The discriminative power of the baseline clinical model (C = 0.82 [0.80–0.83]) was increased by adding GPS (C = 0.84 [0.82–0.85]; NRI events (NRI+) = 10% [2–16]) and CRP/albumin ratio (C = 0.83 [0.82–0.85]; NRI+ = 14% [2–17]). Conclusions: Routine inflammatory biomarkers add prognostic value to clinical factors in older cancer patients.


2014 ◽  
Vol 5 ◽  
pp. S22
Author(s):  
c. Kenis ◽  
P. Heeren ◽  
L. Decoster ◽  
K. Van Puyvelde ◽  
J. De Grève ◽  
...  

2017 ◽  
Vol 33 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Jing Jin ◽  
Kejia Hu ◽  
Yongzhao Zhou ◽  
Weimin Li

Objective: To conduct a meta-analysis of prospective and retrospective studies to reveal the relationship between the Glasgow prognostic score (GPS) and overall survival (OS) or progression-free survival (PFS) in patients with lung cancer. Methods: Correlative studies were included by searching the databases of PubMed, Web of Science, Embase, and PubMed Cochrane Library until April 16, 2017. We combined the hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the correlation between GPS and OS or PFS in patients with lung cancer. Results: Ten studies involving 5,369 participants from several regions were identified through searching databases. In a pooled analysis of all studies, elevated GPS was associated with poorer OS (HR = 2.058; 95% CI, 1.51-2.80; p<0.05). However, the combined data showed no significant relationship between the GPS of 1 or 2, and PFS, respectively. Subgroup analysis showed that the patients with GPS ≥1 had poorer OS compared with those with GPS = 0 (HR = 2.01; 95% CI, 1.75-2.32; p<0.001). A similar trend was observed in patients receiving chemotherapy (HR = 1.66; 95% CI, 1.17-2.36; p<0.05) and surgery (HR = 2.88; 95% CI, 1.59-5.22; p<0.001) when stratified by treatment. Conclusions: Increased level of GPS may have a prognostic value in lung cancer. We detected a statistical difference in the association of elevated GPS and poorer OS, though the association was not significant in PFS settings. However, further studies are warranted to draw firm conclusions.


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