The Prognostic Value of Modified Glasgow Prognostic Score in Pancreatic Cancer: A Meta-analysis

Abstract

Background: Several studies were conducted to explore the prognostic value of modified Glasgow Prognostic Score (mGPS) in pancreatic cancer, which reported contradictory results. The purpose of this meta-analysis was to summarize the prognostic value of mGPS in pancreatic cancer by investigating the correlation between mGPS and overall survival (OS). Methods: A systematic literature search was performed in PubMed, EMBASE, ISI Web of Science, Cochrane library databases and OVID to identify eligible studies published from Jan 1, 2011 to June 20, 2020. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were used to detect the prognostic significance of mGPS in patients with pancreatic cancer. Results: A total of 222 non-repetitive studies were identified, and 20 enrolled studies described the association between survival outcomes and mGPS in pancreatic cancer patients. The results showed a significant correlation between high mGPS and poor OS (HR=1.50, 95% CI=1.20–1.89, P<0.0001). Similar results were observed in the subgroup analyses of OS, which were based on the treatment regimen and research region. Conclusions: Our study suggested the close association between the poor prognosis and high level of mGPS, which will be helpful for future clinical applications in pancreatic cancer patients.

Prognostic value of pretreatment modified Glasgow Prognostic Score in small cell lung cancer: A meta-analysis

“…Only 3 studies explored the predictive role of pretreatment mGPS for PFS in SCLC patients. [31,34,35] The pooled results demonstrated that pretreatment mGPS was significantly associated with PFS (HR = 1.40, 95% CI: 1.13–1.74, P = .002; I 2 = 0.0%, P = .405) (Fig. 3) and patients with elevated mGPS experienced worse PFS.…”

“…Tan et al included 13 studies involving 12,524 urothelial carcinoma patients and demonstrated that a high mGPS was obviously associated with poor OS (mGPS 0/1: HR = 1.33, P = .001; mGPS 0/2: HR = 2.02, P < .001) and PFS (mGPS 0/1: HR = 1.26, P = .021; mGPS 0/2: HR = 1.76, P = .013), recurrence-free survival (RFS) (mGPS 0/1: HR = 1.36, P < .001; mGPS 0/2: HR = 1.70, P < .001) and cancer-specific survival (mGPS 0/2: HR = 1.81, P < .001). [21] Besides, Wu et al [29,33,34,36,37] 1.81 0.96-3.41 .065 92.1 <.001 Japan 4 [30][31][32]35] 2.15 1.68-2.75 <.001 0.0 .953 Tumor stage Mixed 7 [29,30,33,34,[36][37][38] 1.77 1.20-2.63 .004 89.5 <.001 Extensive 3 [31,32,35] 2.37 1.57-3.58 <.001 0.0 .993 Treatment Mixed 3 [29,30,32] 2.66 1.59-4.46 <.001 57.4 .096 Chemotherapy 6 [31,[33][34][35][36][37] 1.68 1.00-2.82 .052 88.7 <.001 Comparison of mGPS mGPS 0 vs 1 5 [29,30,32,33,38] 1.31 1.16-1.49 <.001 0.0 .902 mGPS 0 vs 2 5 [29,30,32,33,38] 2.75 1.77-4.28 <.001 81.3 <.001 Progression-free survival 3 [31,34,35] 1.40 1.13-1.74 .002 ...…”

“…In the past decades, lots of researches have strongly indicated the significant relationship between inflammation and occurrence, development, and metastasis of tumors. [39][40][41] In the early stages of the tumor, inflammatory mediators produced by inflammatory cells, such as cytokines, free radicals, prostaglandins, and growth factors, could induce genetic and epigenetic changes, including point mutations in tumor suppressor genes, Zhou [29] 2015 China 359 Limited + extensive Chemotherapy + others 0 vs 1, 0 vs 2 OS 7 Kurishima [30] 2017 Japan 332 Limited + extensive Chemotherapy + others 0 vs 1, 0 vs 2 OS 7 Minami [31] 2017 Japan 97 Extensive Chemotherapy 0/1 vs 2 OS, PFS 7 Sonehara [32] 2019 Japan 83 Extensive Chemotherapy + others 0 vs 1, 0 vs 2 OS 7 Zhou [33] 2019 China 451 Limited + extensive Chemotherapy 0 vs 1, 0 vs 2 OS 6 Zhan [34] 2019 China 277 Limited + Extensive Chemotherapy 0 vs 1 vs 2 OS, PFS 8 Igawa [35] 2020 Japan 41 Extensive Chemotherapy 0 vs 1/2 OS, PFS 6 Mao [36] 2021 China 118 Limited + extensive Chemotherapy 0 vs 1 vs 2 OS 7 Zhang [37] 2021 China 183 Limited + extensive Chemotherapy 0 vs 1 vs 2 OS 8 Winther-Larsen [38] 2022 Denmark 890 Limited + extensive NR 0 vs 1, 0 vs 2 OS 6 mGPS = modified Glasgow Prognostic Score, NOS = Newcastle-Ottawa Scale, NR = not reported, OS = overall survival, PFS = progression-free survival.…”

How can we better predict the prognosis of patients with pancreatic cancer undergoing surgery using an immune-nutritional scoring system?

“…The immune-nutritional indexes, including PNI, 12 mGPS, 13 NLR, 14 PLR, 15 RDW, 16 and CONUT, 17 were determined based on previous reports. PNI, NLR, and PLR were composed of continuous data, whereas CONUT and mGPS were composed of noncontinuous data.…”

“…8,9 In addition, systemic inflammatory responses are significantly associated with a progressive decline in nutrition and function as well as subsequent adverse outcomes in patients with cancer. 10,11 Various immune-nutritional assessment methods exist, including the prognostic nutrient index (PNI), 12 modified Glasgow prognosis score (mGPS), 13 neutrophil lymphocyte ratio (NLR), 14 platelet-tolymphocyte ratio (PLR), 15 red blood cell distribution (RDW), 16 and controlling nutritional status (CONUT), 17 which have all been reported to predict the prognosis of pancreatic cancer. However, it remains unclear which immune-nutritional index is the most accurate for evaluating the prognosis of pancreatic cancer.…”