Modified Glasgow Prognostic Score as a Prognostic Factor in Patients with Extensive Disease-Small-Cell Lung Cancer: A Retrospective Study in a Single Institute

Abstract

Introduction: Small-cell lung cancer (SCLC) is a very chemosensitive solid tumor but is characterized by rapid progression. The modified Glasgow prognostic score (mGPS) has been shown to be an independent prognostic factor in various tumors. However, there have been few reports regarding the prognostic value of mGPS in extensive disease (ED)-SCLC. Objective: This study was designed to clarify the clinical significance of mGPS focusing on its usefulness as a prognostic indicator for the survival and serial administrations of chemotherapies in patients with ED-SCLC. Methods: We retrospectively analyzed the clinical records of ED-SCLC patients diagnosed and treated at Shinshu University School of Medicine between January 2005 and December 2018. Overall survival (OS) was compared according to mGPS and we examined whether mGPS could be a prognostic factor in ED-SCLC using the Kaplan-Meier method and univariate and multivariate Cox hazard analyses. Results: Eighty-three patients were enrolled in this study. The median OS of mGPS 0, mGPS 1, and mGPS 2 groups were 13.6, 9.2, and 5.7 months, respectively. The OS of the mGPS 0 group was significantly longer than those of mGPS 1 and mGPS 2 groups (log-rank, p = 0.025 and 0.008, respectively). The rates of second-line chemotherapy administration in mGPS 0, mGPS 1, and mGPS 2 groups were 79.4, 61.9, and 33.3%, respectively. The rate in the mGPS 0 group was significantly higher than that in the mGPS 2 group (p = 0.003). Multivariate analyses indicated that mGPS 2 was an independent unfavorable prognostic factor in addition to old age (≥75 years), poor performance status (2–3), and elevated serum lactate dehydrogenase level (≥223 IU/L). Conclusion: In ED-SCLC patients, mGPS was useful as a prognostic indicator for OS.

Lung immune prognostic index as a prognostic factor in patients with small cell lung cancer

“…Systemic immune and inflammatory status in the body are critical in cancer prognosis. Many recent reports have suggested that various markers of systemic inflammation, such as the neutrophil‐to‐lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune‐inflammation index (SII), and modified Glasgow prognostic score (mGPS), would be useful as prognostic factors in SCLC patients . It is also important that these biomarkers may be available in all institutions and are cost‐effective.…”

Inflammation Scores as Prognostic Biomarkers in Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

“…The only score not including lymphocyte count is the mGPS, which is based on two other markers potentially re ecting interleukin-1β: albumin and CRP. We identi ed ve studies (28,30,34,39,42) evaluating the prognostic potential of mGPS in a total of 954 SCLC patients with both LD and ED. A high mGPS score was overall associated with reduced OS, though one of the studies(42) did not report an adjusted HR.…”

“…For one study, the stage of disease was not described (42). The presence of liver metastasis was described in seven studies (21,29,30,34,46,48,51) ALI, advanced lung cancer in ammation index (body mass index x albumin / NLR )); ALP, alkaline phosphate); CT, chemotherapy; ECOG PS, Eastern Coopera status; HALP, haemoglobin × albumin × lymphocytes / platelet count; HGB, haemoglobin; KPS, Karnofsky performance scale; LDH, lactate dehydrogenase; LM M: multivariate; MCV, mean cell volume; MLR, monocyte-to-lymphocyte ratio; mGPS, modi ed Glasgow Prognostic Score (CRP ≤ 10 mg/L and albumin ≥ 35 g 35 g/L: score 1; CRP < 10 mg/L and ≤ 35 g/L: score 1; CRP > 10 mg/L and albumin < 35 g/L: score 2) ; MPV, mean platelet volume; PCI, prophylactic cranial ir lymphocyte ratio; PNI, prognostic nutritional index; RBC, red blod cell count; RT: radiotherapy; SII, systemic immune-in ammation index (= platelet count × neu TCR, thoracic chemo-radiotherapy; U: univariate.…”

“…In the identi ed 33 studies, an adjusted risk estimate of mortality risk between patients with a low versus a high score could only be retrieved in 25 studies (NLR: 16 (17,21,22,24,25,29,32,35,41,(43)(44)(45)(46)(49)(50)(51), PLR: 7 (24,25,34,37,41,50,51), LMR: 2 (21,41), MLR: 2 (46,47), mGPS:4 (28,30,34,39), SII: 3 (24,40,41), ALI:1 (23,26)). Rating and adjustment variables for the individual study are listed in Table 1.…”

Prognostic Significance of the Modified Glasgow Prognostic Score in Patients With Pancreatic Cancer: A Meta-Analysis

“…The mGPS is based on serum albumin (Alb) and C-reactive protein (CRP) and is scored as mGPS 0, 1, and 2. 11 Previous studies have validated the prognostic value of mGPS in various solid tumors, including small cell lung cancer, 12 biliary tract cancer, 13 renal cell carcinoma (RCC), 11 and soft-tissue sarcoma. 14 A variety of studies have also investigated the prognostic significance of mGPS in patients with pancreatic cancer; however, the results were inconsistent.…”