The potential for combined measures of the systemic inflammatory response (SIR) in colon cancer: An analysis of 2,300 patients.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 233-233
Author(s):  
Allan Matthew Golder ◽  
Donald C. McMillan ◽  
David Mansouri ◽  
James Hugh Park ◽  
Campbell SD Roxburgh ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Curative Resection ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Glasgow Prognostic Score ◽  
White Cell ◽  
Tnm Stage ◽  
Single Measure ◽  
Neutrophil Lymphocyte Ratio

233 Background: The preoperative SIR clearly demonstrates independent prognostic significance following curative resection for colon cancer, independent of TNM stage. SIR can be measured either using acute phase proteins, predominantly the modified Glasgow Prognostic Score (mGPS) or using the differential white cell count, predominantly neutrophil-lymphocyte ratio (NLR) or lymphocyte-monocyte ratio (LMR). The present study investigates the potential to combine these scores to better predict overall/cancer specific survival (OS/CSS). Methods: Patients in the West of Scotland undergoing curative resection for Stage I-III colon cancer from 2011-2015 were identified with survival updated until December 2018. Through uni/multivariate analysis (UVA/MVA) we compared the effect on OS/CSS of the SIR measured using a combination of mGPS and either NLR or LMR with other clinicopathological features. Results: 2312 patients were identified having underwent curative surgery. Median follow up time was 60 months and there were 756 deaths during follow up. On UVA: mGPS (0/1/2), NLR ( < 3/3-5/ > 5) and LMR ( < 2.5/2.5+) were significant for OS and CSS (all p < 0.001). In the multivariate model when a combination of mGPS and NLR were entered, both remained significant for OS (mGPS: HR 1.20, p = 0.002 and NLR: HR 1.23, p = 0.001) and CSS (mGPS: HR 1.25, p = 0.003 and NLR: HR 1.21, p = 0.017) adjusted for age, sex, emergency presentation, site, ASA, TNM stage and margin involvement. With mGPS and LMR in the model similar results were seen for OS (mGPS: HR 1.24, p = 0.005 and LMR: HR 1.49, p = 0.003) and CSS (mGPS: HR 1.20 p = 0.001 and LMR: HR 1.45, p < 0.001). When mGPS and NLR were scored 0/1/2 (mGPS 0/1/2 and NLR < 3/3-5/ > 5) and combined to form a cumulative grade (0/1/2/3/4) this offered better stratification of %OS (86/84/72/61/55) than mGPS (83/75/60) or NLR (86/79/66) alone (all p < 0.001). Similar results were seen for %CSS – mGPS (90/79/71), NLR (91/85/75) and combined grade (92/90/77/71/67). Conclusions: The results of the present study show that the combined use of mGPS and a differential white cell-based score (NLR/LMR) stratify OS/CSS better than a single measure of preoperative SIR alone.

Prognostic value of modified Glasgow Prognostic Score (mGPS) and neutrophil-lymphocyte ration (NLR) after curative resection for gastric cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 295-295
Author(s):  
Yusuke Shimodaira ◽  
Sachie Koike ◽  
Yusuke Takahashi ◽  
Masao Okada ◽  
Kaori Hayashibara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Curative Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Rank Test ◽  
Independent Predictive Factor ◽  
Gastric Cancer Patients

295 Background: Several biomarkers based on serum chemistry have been reported to be associated with the prognosis of several types of cancers. This retrospective study aimed to investigate the prognostic value of preoperative mGPS and NLR after curative resection for gastric cancer. Methods: A total of 295 patients who underwent curative gastrectomy for primary gastric cancer at our institution from January 2013 to December 2017 were enrolled in this study. The mGPS was calculated by CRP and Alb using standard thresholds ( > 0.5 mg/dL for CRP and < 3.5 g/dL for Alb). The NLR was defined as absolute neutrophil count divided by absolute lymphocyte count. The survival curves of patients stratified by each parameter were plotted by the Kaplan-Meier method and compared by log-rank test. Multivariate Cox proportional hazards regression models were used to select parameters independently correlated with prognosis. Results: The median follow-up time was 36.7 months, and 29 patients died during follow-up. The estimated 5-year survival rate was 83.1%. Results from the univariate analyses showed mGPS2 (CRP > 0.5 mg/dL and Alb < 3.5 g/dL) was associated with poor survival while NLR and NLRc was not (P < 0.001, P = 0.506, and P = 0.423, respectively). In the multivariate analyses, the mGPS2 was identified as an independent predictive factor for OS in gastric cancer patients after curative resection (HR: 2.624; 95% CI: 1.058-6.505; P = 0.037). Conclusions: Preoperative mGPS2 was associated with worse survival after curative resection of gastric cancer patients. Based on our study, those with mPGS2 may be warranted to receive additional therapy or nutritional support to acquire better survival.

scholarly journals A New Risk Model Predicting Overall Survival Using Preoperative Nutritional and Inflammation Status (NIS) in Patients After Curative Resection of Colorectal Cancer

2021 ◽  
Author(s):  
Tamuro Hayama ◽  
Tsuyoshi Ozawa ◽  
Mitsuo Tsukamoto ◽  
Yoshihisa Fukushima ◽  
Ryu Shimada ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Progression ◽  
Curative Resection ◽  
Risk Model ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
University Hospital ◽  
Rank Test ◽  
Preoperative Body Mass Index ◽  
Neutrophil Lymphocyte Ratio

Abstract It has been shown that nutritional status correlates with survival in patients with various kinds of cancers. Besides, cancer causes inflammation which has been suggested to stimulate cancer progression. Therefore, inflammation status also has shown to reflect prognosis of cancers. In this study, we evaluated several kinds of nutritional and inflammation parameters in preoperative blood samples and constructed new risk model predicting a survival in patients with CRC (colorectal cancers). We retrospectively examined 286 patients with stage I-III CRC who had undergone curative resection in Teikyo University Hospital between 2013 to 2017. The association between overall survival (OS) and preoperative body mass index, albumin (Alb), cholesterol (Chol), and lymphocyte count, white blood cell count (WBC), neutrophil count (Neu), platelet count (Plt), C-reactive protein (CRP) were examined using Kaplan-Meier curve and log rank test. and eventually Alb, Chol, Neu, Plt, and CRP were shown to correlate with OS. Alb, Chol, Neu, Plt, and CRP were shown to correlate with OS. We constructed a new risk model (NIS: nutrition inflammation status) using these factors, and compared its usefulness with known models such as CRP-albumin ratio (CAR), Glasgow prognostic score (GPS), prognostic nutritional index (PNI), and neutrophil lymphocyte ratio (NLR). NIS prepared using nutritional indicators and inflammatory findings was useful as a new model for predicting overall survival in patients undergoing curative resection for CRC, compared with known models.

scholarly journals The values of several inflammatory markers, including the neutrophil/lymphocyte ratio, in patients with pancreatic cancer treated by curative resection followed by adjuvant chemotherapy

2017 ◽  
Author(s):  
Yusuke Nakayama ◽  
Naoto Gotohda ◽  
Shinichiro Takahashi ◽  
Masaru Konishi ◽  
Ryuichi Hayashi
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Inflammatory Markers ◽  
Curative Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Objective: The aim of this study was to determine the relationship between the values of several systemic inflammatory markers and the prognosis in pancreatic cancer patients treated by curative resection followed by adjuvant chemotherapy. Methods: A total of 110 pancreatic cancer patients who treated by curative resection followed by adjuvant chemotherapy were reviewed for this study. Univariate and multivariate analyses were performed to identify the clinicopathological factors influencing the overall survival, including the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), Glasgow prognostic score (GPS), and the direction of change of the NLR (increase or decrease) after one cycle of adjuvant chemotherapy as compared to the value recorded prior to the start of the chemotherapy. Results: A multivariate analysis identified only the direction of change of the NLR after the first cycle of adjuvant chemotherapy as an independent risk factor for the overall survival (NLR decrease vs. NLR increase, HR=1.925; P=0.044). The NLR, PLR and GPS were not identified as significant predictors of the overall survival. Conclusions: The direction of change of the NLR after the first cycle of adjuvant chemotherapy may help in predicting the effect of chemotherapy in pancreatic cancer patients treated by curative resection followed by adjuvant chemotherapy.

scholarly journals Inflammation-based assessment for the risk stratification of mortality in patients with heart failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tadashi Itagaki ◽  
Hirohiko Motoki ◽  
Kyuhachi Otagiri ◽  
Keisuke Machida ◽  
Takahiro Takeuchi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Glasgow Prognostic Score ◽  
Left Ventricular ◽  
Functional Class ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure

AbstractThe Glasgow Prognostic Score (GPS) has been established as a useful resource to evaluate inflammation and malnutrition and predict prognosis in several cancers. However, its prognostic significance in patients with heart failure (HF) is not well established. To investigate the association between the GPS and mortality in patients with HF, we assessed 870 patients who were 20 years old and more and had been admitted for acute decompensated HF. The GPS ranged from 0 to 2 points as previously reported. Over the 18-month follow-up (follow-up rate, 83.9%), 143 patients died. Increasing GPS was associated with higher HF severity assessed by New York Heart Association functional class and B-type natriuretic peptide (BNP) levels. Kaplan–Meier analysis showed significant associations for mortality and increased GPS. In multivariate analysis, compared to the GPS 0 group, the GPS 2 group was associated with high mortality (hazard ratio 2.92, 95% confidence interval 1.77–4.81, p < 0.001) after adjustment for age, sex, blood pressure, HF history, HF severity, hemoglobin, renal function, sodium, BNP, left ventricular ejection fraction, and anti-HF medications. In conclusion, high GPS was significantly associated with worse prognosis in patients with HF. Inflammation-based assessment by the GPS may enable simple evaluation of HF severity and prognosis.

Clinical utility of the preoperative Glasgow prognostic score in patients undergoing potentially curative resection for colorectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3611-3611
Author(s):  
Donald C. Mcmillan ◽  
Campbell SD Roxburgh ◽  
Paul G Horgan
Keyword(s):  
Colorectal Cancer ◽  
Clinical Utility ◽  
Curative Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Tnm Stage ◽  
Stage Ii ◽  
Royal Infirmary ◽  
Cancer Specific Survival ◽  
Study Results

3611 Background: There is now good evidence that, in addition to TNM stage, the pre-operative combination of the standardised measurements of C-reactive protein and albumin, the Glasgow Prognostic Score (mGPS) provides valuable prognostic information. The aim of the present study was to examine the clinical application of the pre-operative mGPS in a large mature cohort of patients undergoing potentially curative resection for colorectal cancer. Methods: From a prospectively maintained database, consecutive patients (n= 797) with histologically proven colorectal cancer who were considered to have undergone potentially curative resection between January 1997 and December 2010 in a single surgical unit at the Royal Infirmary, Glasgow were included in the study. Results: Patients with an elevated mGPS were more likely to be older (p<0.001), female (p<0.05), have colonic tumours (<0.001), present as an emergency (p<0.001), had higher TNM stage (p<0.05) and more likely to die of their disease (p<0.01). The median follow-up was 66 months and using 3 year cancer-specific mortality as an endpoint, the area under the receiver operator curve was 0.652 (95% CI, 0.591–0.714; p<0.001) for the mGPS and 0.668 (95% CI, 0.610–0.727; p<0.001) for TNM stage. The cancer-specific survival, at 3 years, varied between 86% and 64% according to the mGPS and between 88% and 72% according to TNM stage. The cancer-specific survival, at 3 years, in patients with a mGPS 0 was 91% and 81% for TNM stage II and III respectively. The cancer-specific survival, at 3 years, in patients with a mGPS 1 was 89% and 66% for TNM stage II and III respectively. The cancer-specific survival, at 3 years, in patients with a mGPS 2 was 77% and 43% for TNM stage II and III respectively. Conclusions: The results of the present study show the clinical utility of the pre-operative mGPS in predicting cancer specific survival of potentially curative surgery for colorectal cancer.

scholarly journals The Glasgow Prognostic Score Determined During Concurrent Chemoradiotherapy Is an Independent Predictor of Survival for Cervical Cancer

2015 ◽  
Vol 25 (7) ◽  
pp. 1306-1314 ◽  
Author(s):  
Takeshi Nishida ◽  
Keiichiro Nakamura ◽  
Junko Haraga ◽  
Chikako Ogawa ◽  
Tomoyuki Kusumoto ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Multivariate Analyses ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Kaplan Meier ◽  
The Glasgow Prognostic Score ◽  
Prediction Of Prognosis

ObjectiveThe Glasgow prognostic score (GPS) determined at pretreatment is important in the prediction of prognosis in various cancers. We investigated if the GPS used both at pretreatment and during concurrent chemoradiotherapy (CCRT) could predict the prognosis of patients with cervical cancer.MethodsWe collected GPS and clinicopathological data from the medical records of 91 patients who underwent CCRT for cervical cancer; their GPSs at pretreatment and during CCRT were retrospectively analyzed for correlations with recurrence and survival. Statistical analyses were performed using the Mann-WhitneyUtest. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox’s proportional hazard regression was used for univariate and multivariate analyses.ResultsThe median follow-up for all patients who were alive at the time of last follow-up was 38.0 months (range, 1–108 months). The DFS and OS rates of patients with a high GPS during CCRT (GPS 1 + 2; 55 patients; 60.4%) were significantly shorter than those for patients with a low GPS (GPS 0; 36 patients; 39.6%) (DFS,P< 0.001; OS,P< 0.001). Furthermore, multivariate analyses showed that high GPS during CCRT was an independent prognostic factor of survival for OS (P= 0.008).ConclusionsDuring CCRT, a high GPS was revealed to be an important predictor of survival for cervical cancer.

scholarly journals Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection

2020 ◽  
Author(s):  
Donogh Maguire ◽  
Marylynne Woods ◽  
Conor Richards ◽  
Ross Dolan ◽  
Jesse Wilson Veitch ◽  
...  
Keyword(s):  
Heart Failure ◽  
Medical History ◽  
Teaching Hospital ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Early Warning Score ◽  
Past Medical History ◽  
Urban Teaching ◽  
Neutrophil Lymphocyte Ratio ◽  
History Of

Abstract BackgroundSevere COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure. MethodsElectronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020 - 1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion.ResultsOf the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age>70 years (p<0.001), past medical history of cognitive impairment (p<0.001), previous delirium (p<0.001), clinical frailty score>3 (p<0.001), hypertension (p<0.05), heart failure (p<0.01), national early warning score (NEWS) >4 (p<0.01), positive CXR (p<0.01), and subsequent positive COVID-19 swab (p<0.001) were associated with 30-day mortality. CRP>80 mg/L (p<0.05), albumin <35g/L (p<0.05), peri-operative Glasgow Prognostic Score (poGPS) (p<0.05), lymphocytes <1.5 109/l (p<0.05), neutrophil lymphocyte ratio (p<0.001), haematocrit (<0.40 L/L (male) / <0.37 L/L (female)) (p<0.01), urea>7.5 mmol/L (p<0.001), creatinine >130 mmol/L (p<0.05) and elevated urea: albumin ratio (<0.001) were also associated with 30-day mortality.On analysis, age >70 years (O.R. 3.9, 95% C.I. 1.4 – 8.2, p<0.001), past medical history of heart failure (O.R. 3.3, 95% C.I. 1.2 – 19.3, p<0.05), NEWS >4 (O.R. 2.4, 95% C.I. 1.1 – 4.4, p<0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p<0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1 – 4.4, p<0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n=122), age >70 years (O.R. 4.7, 95% C.I. 2.0 - 11.3, p<0.001), past medical history of heart failure (O.R. 4.4, 95% C.I. 1.2 – 20.5, p<0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1- 5.1, p<0.05) remained independently associated with 30-days mortality.ConclusionAge > 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.

scholarly journals The prognostic significance of inflammation-based scores in patients with ampullary carcinoma after pancreaticoduodenectomy

2020 ◽  
Author(s):  
Shuxin Sun ◽  
Chaobin He ◽  
Jun Wang ◽  
Xin Huang ◽  
Jiali Wu ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Glasgow Prognostic Score ◽  
Prognostic Nutritional Index ◽  
Significant Prognostic Factor ◽  
Entire Cohort ◽  
Lymphocyte Ratio ◽  
Survival Differences

Abstract Background Growing evidence indicates that systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with the clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of the inflammatory indexes in patients suffering from ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD). Methods We retrospectively reviewed a database of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value of survival. The survival differences of these indexes were compared by Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of progress-free survival (PFS) and overall survival (OS). Results The estimated 1-, 2-, and 3-year OS and PFS rates were 83.9%, 65.8%, 55.2% and 58.0%, 42.8%, 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and PFS when they were stratified by these inflammation-based indexes. The comparisons of AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed highest prognostic value, compared to other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor in terms of OS and PFS. Conclusion Specific inflammatory indexes, such as NLR, PLR and PI, were found to be able to predict the OS or PFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting prognosis of patients with AC after PD procedure.

scholarly journals Changes and prognostic impact of inflammatory nutritional factors during neoadjuvant chemoradiotherapy for patients with resectable and borderline resectable pancreatic cancer

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Minoru Oshima ◽  
Keiichi Okano ◽  
Hironobu Suto ◽  
Yasuhisa Ando ◽  
Hideki Kamada ◽  
...  
Keyword(s):  
External Beam Radiotherapy ◽  
Prognostic Score ◽  
Neoadjuvant Chemoradiotherapy ◽  
Glasgow Prognostic Score ◽  
Ductal Adenocarcinoma ◽  
Prognostic Impact ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Nutritional Factors ◽  
Neutrophil Lymphocyte Ratio

Abstract Background Inflammatory nutritional factors, such as the neutrophil/lymphocyte ratio (NLR), Glasgow Prognostic Score (GPS), modified GPS (mGPS), and C-reactive protein/albumin (CRP/Alb) ratio, have prognostic values in many types of cancer. In this study, the prognostic values of inflammatory nutritional scores were evaluated in the patients with resectable or borderline resectable pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant chemoradiotherapy (NACRT). Methods A total of 49 patients who underwent pancreatectomy after NACRT from September 2009 to May 2016 were enrolled. The NACRT consisted of hypofractionated external-beam radiotherapy (30 Gy in 10 fractions) with concurrent S-1 (60 mg/m2) delivered 5 days/week for 2 weeks before pancreatectomy. Inflammatory nutritional scores were determined before and after NACRT in this series. Results The median NLR increased after NACRT (from 2.067 to 3.302), with statistical difference (p < 0.001). In multivariate analysis, high pre-NACRT mGPS (2 or 1; p = 0.0478) and significant increase in CRP/Alb ratio after NACRT (≧ 0.077; p = 0.0036) were associated with shorter overall survival. All patients were divided into two groups according to the ΔCRP/Alb ratio after NACRT: the group with high ΔCRP/Alb ratio (≧ 0.077) and the group with low ΔCRP/Alb ratio (< 0.077). The group with high ΔCRP/Alb ratio after NACRT (n = 13) not only had higher post-NACRT CRP levels (p < 0.001) but also had lower post-NACRT Alb levels (p = 0.002). Patients in the group with high ΔCRP/Alb ratio lost more body weight during NACRT (p = 0.03). Conclusion In addition to pre-NACRT mGPS, ΔCRP/Alb after NACRT could provide prognostic value in the patients with PDAC treated by NACRT.

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