Research Papers:

Glasgow prognostic score is a better predictor of the long-term survival in patients with gastric cancer, compared to the modified Glasgow prognostic score or high-sensitivity modified Glasgow prognostic score

Noriyuki Hirahara _, Takeshi Matsubara, Shunsuke Kaji, Yasunari Kawabata, Ryoji Hyakudomi, Tetsu Yamamoto, Yuki Uchida, Kazunari Ishitobi, Kiyoe Takai and Yoshitsugu Tajima

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Oncotarget. 2020; 11:4169-4177. https://doi.org/10.18632/oncotarget.27796

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Noriyuki Hirahara1, Takeshi Matsubara1, Shunsuke Kaji1, Yasunari Kawabata1, Ryoji Hyakudomi1, Tetsu Yamamoto1, Yuki Uchida1, Kazunari Ishitobi1, Kiyoe Takai1 and Yoshitsugu Tajima1

1 Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan

Correspondence to:

Noriyuki Hirahara,email: [email protected]

Keywords: glasgow prognostic score (GPS); modified GPS (mGPS); high-sensitivity mGPS (HS-mGPS); C-reactive protein; gastric cancer

Received: August 31, 2020     Accepted: October 17, 2020     Published: November 10, 2020

Copyright: © 2020 Hirahara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Inflammation influences cancer progression by increasing catabolism and impairing nutrient absorption. We compared the prognostic ability of three inflammation-based prognostic scoring systems—the Glasgow prognostic score (GPS), modified GPS (mGPS), and high-sensitivity mGPS (HS-mGPS)—in gastric cancer patients.

Materials and Methods: We retrospectively examined 434 curatively resected gastric cancer patients to evaluate the prognostic ability of scoring systems for overall survival (OS) and cancer-specific survival (CSS).

Results: OS analysis identified the following independent prognostic factors: GPS model: pathological stage (pStage, p < 0.001), carcinoembryonic antigen (CEA, p = 0.004), and GPS 1 (hazard ratio [HR], 1.929; 95% confidence interval [CI], 1.152-3.228; p = 0.013); mGPS model: body mass index (BMI, p = 0.027), pStage (p < 0.001), and CEA (p < 0.001); HS-mGPS model: BMI (p = 0.029), pStage (p < 0.001), and CEA (p = 0.003). mGPS and HS-mGPS were not independent prognostic factors for OS. CSS analysis of the GPS model identified pStage (p < 0.001), CEA (p = 0.015), and GPS 1 (HR; 2.095, 95% CI; 1.025–4.283; p = 0.043) and 2 (HR, 2.812; 95% CI, 1.111–7.116; p = 0.029) as independent prognostic factors; however, mGPS and HS-mGPS were not independent prognostic factors for CSS. Log-rank tests demonstrated significant differences in OS among patients with GPS 0 vs. 1 (p < 0.001) and 0 vs. 2 (p < 0.001) and in CSS among the three GPS (0 vs. 1; p = 0.005, 0 vs. 2; p < 0.001, 1 vs. 2; p = 0.009).

Conclusions: GPS most reliably predicts long-term survival of gastric cancer patients.

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