The high-sensitivity modified Glasgow prognostic score is superior to the modified Glasgow prognostic score as a prognostic predictor for head and neck cancer
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Nobuhiro Hanai1, Michi Sawabe1,2, Takahiro Kimura1,3, Hidenori Suzuki1, Taijiro Ozawa1,4, Hitoshi Hirakawa1,5, Yujiro Fukuda1,6 and Yasuhisa Hasegawa1,7
1Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Aichi, Japan
2Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
3Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
4Department of Otolaryngology, Toyohashi Municipal Hospital, Aichi, Japan
5Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
6Department of Otolaryngology, Kawasaki Medical School, Okayama, Japan
7Department of Head and Neck Surgery and Otolaryngology, Asahi University Hospital, Gifu, Japan
Nobuhiro Hanai, email: [email protected]
Keywords: modified Glasgow prognostic score; high-sensitivity modified Glasgow prognostic score; head and neck cancer; C-reactive protein; survival
Received: August 06, 2018 Accepted: November 26, 2018 Published: December 11, 2018
Background: There is increasing evidence that the inflammatory indices of modified Glasgow prognostic score (mGPS) and high-sensitivity mGPS (HS-mGPS) play important roles in predicting the survival in many cancer; however, evidence supporting such an association in head and neck cancer (HNC) is scarce.
Materials and Methods: We evaluated the impact of the mGPS and HS-mGPS on the overall survival (OS) in 129 patients with HNC treated at Aichi Cancer Center Central Hospital from 2012-2013. The mGPS was calculated as follows: mGPS of 0, C-reactive protein (CRP) ≤1.0 mg/dl; 1, CRP >1.0 mg/dl; 2, CRP>1.0 mg/dl and albumin <3.5 mg/dl. Regarding the HS-mGPS, the CRP threshold level was set as 0.3 mg/dl. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated by Cox proportional hazard models after adjusting for potential confounders.
Results: The prognosis of HNC worsened significantly as both the mGPS and HS-mGPS increased in a univariate analysis. After adjusting for covariates, the HS-mGPS was significantly associated with the OS (adjusted HR for HS-mGPS of 2 compared to an HS-mGPS of 0 [HRscore2-0] 3.14 [95% CI: 1.23-8.07], Ptrend < 0.001), while the mGPS was suggested to be associated with the survival (HRscore2-0 2.37 [95% CI:0.89-6.33], Ptrend = 0.145). Even after stratification by clinical covariates, these associations persisted.
Conclusion: We conclude that the HS-mGPS is useful as an independent prognostic factor in HNC.
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