, Tokyo, Japan.
Int J Clin Oncol. 2018 Jun;23(3):539-546. doi: 10.1007/s10147-017-1221-z. Epub 2018 Jan 5.
The aim of the present study was to evaluate the prognostic significance of the Glasgow Prognostic Score (GPS) in metastatic renal cell carcinoma (mRCC) patients treated by cytoreductive nephrectomy (CN), and the accuracy of the GPS as a prognostic factor.
We retrospectively analyzed the data of patients who underwent CN for mRCC between March 1984 and August 2015. In accordance with the GPS criteria, the patients were classified into three groups: GPS 0: C-reactive protein (CRP) ≤ 1.0 mg/dl and albumin ≥ 3.5 g/dl; GPS 1: CRP > 1.0 mg/dl or albumin < 3.5 g/dl; and GPS 2: CRP > 1.0 mg/dl and albumin < 3.5 g/dl.
We enrolled 170 patients (72% male; median age 63.5 years). Fifty-six (33%), 67 (39%), and 47 (28%) patients had a GPS of 0, 1, and 2, respectively. The median overall survivals after CN were 52.4, 19.1, and 8.9 months for patients with a GPS of 0, 1, and 2, respectively (P < 0.0001). In addition to the GPS, Eastern Cooperative Oncology Group performance status (ECOG-PS), Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification, histology, sarcomatoid change, clinical T stage, primary tumor size, number of metastatic organs, non-regional lymph node metastasis, and liver metastasis were included in the Cox hazards regression model. Multivariate analysis of these factors revealed that the GPS was an independent prognostic factor of overall survival (P < 0.0001). Harrell's concordance index in the multivariate prognostic model based on ECOG-PS, MSKCC risk criteria, histology, sarcomatoid change, clinical T stage, primary tumor size, number of metastatic organs, non-regional lymph node metastasis, and liver metastasis was 0.609, which increased to 0.652 after the inclusion of the GPS.
GPS represents an independent prognostic factor for patients who undergo CN for mRCC.
本研究旨在评估细胞减灭性肾切除术（CN）治疗转移性肾细胞癌（mRCC）患者时格拉斯哥预后评分（GPS）的预后意义，以及 GPS 作为预后因素的准确性。
我们回顾性分析了 1984 年 3 月至 2015 年 8 月间接受 CN 治疗的 mRCC 患者的数据。根据 GPS 标准，患者被分为三组：GPS0：C 反应蛋白（CRP）≤1.0mg/dl 且白蛋白≥3.5g/dl；GPS1：CRP＞1.0mg/dl 或白蛋白＜3.5g/dl；GPS2：CRP＞1.0mg/dl 且白蛋白＜3.5g/dl。
我们纳入了 170 例患者（72%为男性；中位年龄 63.5 岁）。56（33%）、67（39%）和 47（28%）例患者的 GPS 分别为 0、1 和 2。CN 后中位总生存期分别为 GPS0、GPS1 和 GPS2 患者的 52.4、19.1 和 8.9 个月（P＜0.0001）。除了 GPS 外，东部肿瘤协作组表现状态（ECOG-PS）、纪念斯隆凯特琳癌症中心（MSKCC）风险分类、组织学、肉瘤样变、临床 T 分期、原发肿瘤大小、转移器官数量、非区域性淋巴结转移和肝转移也被纳入 Cox 风险回归模型。对这些因素的多变量分析显示，GPS 是总生存的独立预后因素（P＜0.0001）。基于 ECOG-PS、MSKCC 风险标准、组织学、肉瘤样变、临床 T 分期、原发肿瘤大小、转移器官数量、非区域性淋巴结转移和肝转移的多变量预后模型的 Harrell 一致性指数为 0.609，纳入 GPS 后增加到 0.652。
GPS 是接受 mRCC 细胞减灭性肾切除术患者的独立预后因素。
