Biliary drainage improves the predictive value of modified Glasgow Prognostic Scores in inoperable pancreatic cancer

Abstract

ObjectiveTo assess the influence of biliary drainage to cholangitis on modified Glasgow Prognostic Score (mGPS) in patients with pancreatic cancer.MethodsmGPS was calculated before and after biliary drainage in 47 consecutive patients with inoperable pancreatic cancer who were receiving chemotherapy. Biliary drainage was indicated for malignant obstructive jaundice that prevented the administration of chemotherapy. To elucidate mGPS values, serum levels of CRP and albumin were measured at the time of diagnosis (before biliary drainage). Overall survival was evaluated and risk factors, which contribute to overall survival, were examined.ResultsBiliary drainage was performed in 15 patients. Using values obtained before biliary drainage, there were no significant differences in median survival time between patients with a mGPS of 0 and those with a mGPS of 1 or 2 (10.7 vs. 9.4 months; p = 0.757). However, using values obtained after biliary drainage, median survival time was significantly higher in patients with a mGPS of 0 than in those with a mGPS of 1 or 2 (11.4 vs. 4.7 months; p = 0.002). Multivariate analysis revealed that a mGPS of 1 or 2 (HR: 3.38; 95% CI: 1.35–8.46, p = 0.009), a carbohydrate antigen 19–9 >1000 U/mL (2.52; 1.22–5.23, p = 0.013), a performance status of 2 (7.68; 2.72–21.28, p = 0.001), carcinoembryonic antigen level >10 ng/mL (2.29; 1.13–4.61, p = 0.021) were independently associated with overall survival.ConclusionmGPS values obtained after biliary drainage appear to be a more reliable indicator of overall survival in patients with inoperable pancreatic cancer.

Prognostic and clinical significance of modified glasgow prognostic score in pancreatic cancer: a meta-analysis of 4,629 patients

“…Two of the included studies were conference abstracts [ 8 , 9 ], and 23 studies were full-text articles [ 6 , 7 , 10 – 30 ]. Thirteen studies [ 6 – 10 , 13 , 14 , 17 , 20 – 22 , 27 , 29 ] recruited patients with pancreatic ductal adenocarcinoma (PDAC) and 12 studies [ 11 , 12 , 15 , 16 , 18 , 19 , 23 – 26 , 28 , 30 ] enrolled PC patients. Hazard ratios (HRs) and 95% confidence intervals (CIs) of multivariate analysis (MVA) were extracted from 19 studies [ 6 – 9 , 11 , 12 , 14 – 16 , 18 , 21 , 23 – 30 ] and 6 studies [ 10 , 13 , 17 , 19 , 20 , 22 ] provided univariate analysis (UVA) HRs and 95% CIs.…”

“…Some studies [ 6 – 15 ] have explored the prognostic efficiency of mGPS in PC, but the results remain conflicting. For example, some clinicians [ 9 , 12 , 14 , 16 ] reported that elevated mGPS was a significant indicator of poor prognosis in patients with PC; however, other researchers found the association between mGPS and patient survival to be insignificant [ 7 , 17 , 18 ]. Therefore, we collected data from eligible studies and performed a meta-analysis to evaluate the prognostic role of mGPS in patients with PC.…”

The prognostic value of modified Glasgow Prognostic Score in pancreatic cancer: a meta-analysis

“…1 , the literature search process was summarized in the flow diagram according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) [ 23 ]. Ultimately, 20 studies [ 8 , 15 – 18 , 24 – 38 ] including 6512 patients were enrolled in this meta-analysis after excluding ineligible studies.

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Clinical Impact of Nutrition and Inflammation Assessment Tools in Pancreatic Cancer Treatment

“…is categorized as follows: score 2 cases have both elevated CRP (>10 mg/l) and low albumin (<35 g/l); score 1 cases have elevated CRP (>10 mg/l) or low albumin (<35 g/l); and score 0 cases have both normal CRP (≤10 mg/l) and normal albumin (≥35 g/l). There were 19 studies evaluating the clinical impacts of GPS/mGPS in pancreatic cancer (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). The first study was reported in 2011.…”