Department of Urology, Osaka Medical College, Takatsuki City, Osaka, Japan.
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ann Surg Oncol. 2017 Sep;24(9):2787-2793. doi: 10.1245/s10434-017-5948-6. Epub 2017 Jun 22.
The modified Glasgow Prognostic Score (mGPS) by measurement of serum C-reactive protein and albumin levels has been shown to provide prognostic value in various cancer types. The purpose of this study was to evaluate whether preoperative assessment of the mGPS predicts patient survival outcome in renal cell carcinoma (RCC).
Clinicopathological and follow-up data in 219 RCC patients, all of whom underwent curative or non-curative nephrectomy, were collected. Overall survival (OS) and cancer-specific survival (CSS) after nephrectomy were evaluated, and univariate and multivariate analyses were conducted to assess the predictive value of the variables, including the mGPS.
During the median follow-up of 57 months, 53 patients (24.2%) were deceased within 22 months of the median OS. The 5-year OS rate from nephrectomy was 85.9 and 18.8% in non-metastatic (n = 195) and metastatic (n = 24) patients, respectively. Increasing mGPS was associated with shorter OS in non-metastatic patients (2-year OS rate of 98.2% in mGPS0, 73.3% in mGPS1, and 44.4% in mGPS2; hazard ratio [HR] 9.96, 95% confidence interval [CI] 4.88-20.13, p < 0.001), whereas no significant difference in OS according to the mGPS was seen in metastatic patients (HR 2.01, 95% CI 0.79-5.16, p = 0.137). On multivariate analysis, the mGPS remained as an independent predictor for OS (HR 5.24, 95% CI 1.39-19.77, p = 0.015) and CSS (HR 4.69, 95% CI 1.13-20.96, p = 0.034) in non-metastatic RCC patients.
The mGPS appeared to be a reliable, preoperatively defined predictive marker with widely standardized protocol in non-metastatic RCC, and should therefore be considered in treatment decision making for RCC patients.
通过测量血清 C 反应蛋白和白蛋白水平得出的改良格拉斯哥预后评分（mGPS）已被证明在多种癌症类型中具有预后价值。本研究的目的是评估术前 mGPS 评估是否可预测肾细胞癌（RCC）患者的生存结局。
收集了 219 例接受根治性或非根治性肾切除术的 RCC 患者的临床病理和随访数据。评估了肾切除术后的总生存（OS）和癌症特异性生存（CSS），并进行了单因素和多因素分析，以评估包括 mGPS 在内的变量的预测价值。
在中位随访 57 个月期间，53 例患者（24.2%）在中位 OS 后 22 个月内死亡。无转移（n=195）和转移（n=24）患者的 5 年 OS 率分别为 85.9%和 18.8%。mGPS 升高与无转移患者的 OS 缩短相关（mGPS0 患者的 2 年 OS 率为 98.2%，mGPS1 为 73.3%，mGPS2 为 44.4%；风险比[HR]9.96，95%置信区间[CI]4.88-20.13，p<0.001），而转移患者的 OS 则根据 mGPS 无显著差异（HR 2.01，95%CI 0.79-5.16，p=0.137）。多因素分析显示，mGPS 仍然是无转移 RCC 患者 OS（HR 5.24，95%CI 1.39-19.77，p=0.015）和 CSS（HR 4.69，95%CI 1.13-20.96，p=0.034）的独立预测因子。
mGPS 似乎是一种可靠的、术前定义的预测标志物，具有广泛标准化的方案，因此应在 RCC 患者的治疗决策中考虑。
