Shim Sung Ryul, Kim Se Joong, Kim Sun Il, Cho Dae Sung
Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
Department of Urology, Ajou University School of Medicine, Suwon, Korea.
World J Urol. 2017 May;35(5):771-780. doi: 10.1007/s00345-016-1940-1. Epub 2016 Sep 24.
Glasgow Prognostic Score (GPS) has been reported to predict oncologic outcomes in various type of cancer. However, their prognostic value in patients with renal cell carcinoma (RCC) is unclear. In this meta-analysis, we evaluated the prognostic significance of GPS in RCC patients.
We performed comprehensive searches of electronic databases to identify studies that evaluated the prognostic impact of pretreatment GPS in RCC patients. The end points were cancer-specific survival (CSS), recurrence-free/disease-free survival (RFS/DFS). Meta-analysis using random-effects models was performed to calculate hazard ratios (HRs) or odds ratios with 95 % confidence intervals (CIs).
Nine retrospective, observational, cohort studies involving 2096 patients were included. Seven studies evaluated CSS, and three evaluated RFS. Our results showed that higher GPS (0 vs. 1 vs. 2) was significantly predictive of poorer CSS (HR 3.68, 95 % CI 2.52-5.40, p < 0.001) and RFS/DFS (HR 2.83, 95 % CI 1.86-4.30, p < 0.001) in patients with RCC. These findings were robust when stratified by sample size, presence of metastasis, and study region. We also conducted subgroup analysis by assessment of Newcastle-Ottawa quality assessment scale (NOS) score, and the HRs were 2.708 (95 % CI 1.969, 3.725) in under 7 points group, 3.685 (95 % CI 2.516, 5.396) in over than 7 points group in CSS. Meta-regression analysis indicated that NOS score group had a significant difference in HRs (p = 0.032).
Higher GPS is associated with tumor progression and is predictive of poorer survival in patients with RCC. Therefore, GPS may help to inform treatment decisions and predict treatment outcomes.
据报道，格拉斯哥预后评分（GPS）可预测多种类型癌症的肿瘤学结局。然而，其在肾细胞癌（RCC）患者中的预后价值尚不清楚。在这项荟萃分析中，我们评估了GPS在RCC患者中的预后意义。
我们对电子数据库进行了全面检索，以确定评估术前GPS对RCC患者预后影响的研究。终点为癌症特异性生存（CSS）、无复发生存/无病生存（RFS/DFS）。采用随机效应模型进行荟萃分析，以计算风险比（HRs）或比值比及其95%置信区间（CIs）。
纳入了9项涉及2096例患者的回顾性、观察性队列研究。7项研究评估了CSS，3项评估了RFS。我们的结果显示，较高的GPS（0 vs. 1 vs. 2）在RCC患者中显著预示着较差的CSS（HR 3.68，95%CI 2.52 - 5.40，p < 0.001）和RFS/DFS（HR 2.83，95%CI 1.86 - 4.30，p < 0.001）。当按样本量、转移情况和研究地区分层时，这些结果是可靠的。我们还通过评估纽卡斯尔-渥太华质量评估量表（NOS）评分进行了亚组分析，在CSS方面，7分以下组的HR为2.708（95%CI 1.969，3.725），7分以上组为3.685（95%CI 2.516，5.396）。Meta回归分析表明，NOS评分组的HR存在显著差异（p = 0.032）。
较高的GPS与肿瘤进展相关，可预示RCC患者较差的生存情况。因此，GPS可能有助于指导治疗决策并预测治疗结果。
