Prognostic value of inflammation-based scores in patients with osteosarcoma

Abstract

Systemic inflammation responses have been associated with cancer development and progression. C-reactive protein (CRP), Glasgow prognostic score (GPS), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and neutrophil-platelet score (NPS) have been shown to be independent risk factors in various types of malignant tumors. This retrospective analysis of 162 osteosarcoma cases was performed to estimate their predictive value of survival in osteosarcoma. All statistical analyses were performed by SPSS statistical software. Receiver operating characteristic (ROC) analysis was generated to set optimal thresholds; area under the curve (AUC) was used to show the discriminatory abilities of inflammation-based scores; Kaplan-Meier analysis was performed to plot the survival curve; cox regression models were employed to determine the independent prognostic factors. The optimal cut-off points of NLR, PLR, and LMR were 2.57, 123.5 and 4.73, respectively. GPS and NLR had a markedly larger AUC than CRP, PLR and LMR. High levels of CRP, GPS, NLR, PLR, and low level of LMR were significantly associated with adverse prognosis (P < 0.05). Multivariate Cox regression analyses revealed that GPS, NLR, and occurrence of metastasis were top risk factors associated with death of osteosarcoma patients.

The contribution of immune infiltrates and the local microenvironment in the pathogenesis of osteosarcoma

“…Knowledges on this dialog will be described in details in the following chapter. Bone marrow microenvironment is also mainly associated with the hematopoietic homeostasis and consequently is enriched in Glasgow prognostic score, neutrophil-lymphocyte ratio), the occurrence of metastases and the overall survival [39]. Similarly, lymphocyte/monocyte ratio appeared associated to the overall survival of patients strengthening the role of immune cells in osteosarcoma development [40].…”

The Prognostic Role of Glasgow Prognostic Score and C-reactive Protein to Albumin Ratio for Sarcoma: A System Review and Meta-Analysis

“…This exceptional study was excluded because the data cannot be adequately transformed. Finally, 12 eligible studies with 2695 patients were included in this meta-analysis [30][31][32][33][34][35][36][37][38][39][40][41]. There is no disagreement among the two investigators during the data extraction process.…”

“…The main features of the 12 included studies are summarized in Table 1. In short, four studies were conducted in Europe (1 in UK and 3 in Denmark) [30,32,35,40], while the other eight were in Asia (6 in China and 2 in Japan) [31,33,34,[36][37][38][39][40][41]. The sample size ranged from 83 to 888, while the follow-up time ranged from 20.3 months to 19 years.…”

“…Five studies focused on bone sarcoma patients [30,31,33,34,41], another five focused on soft tissue sarcoma patients [35][36][37][38][39], and the other two focused on both bone and soft tissue sarcoma patients [32,40]. Five of the 12 included studies declared that patients with medical conditions known to affect systemic inflammation status were excluded [31,33,34,36,38]. According to the Newcastle-Ottawa Scale criteria, all 12 articles were rated as high quality (Table 1).…”

“…The prognostic significance of GPS and CAR has also been investigated in sarcoma patients, and controversial results have also been reported [30][31][32][33][34][35][36][37][38][39][40][41][42]. To our knowledge, no system review or meta-analysis has been conducted on this subject for sarcoma.…”