Pan Mingmei, Zhao Yun, He Jianbo, Wu Huanqiong, Pan Yujia, Yu Qitao, Zhou Shaozhang
College of Oncology, Guangxi Medical University, No.22 Shuangyong Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China.
Department of Respiratory Oncology, Guangxi Medical University Affiliated Tumor Hospital, No.71 Heti Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China.
J Cancer. 2021 Mar 1;12(8):2395-2402. doi: 10.7150/jca.52215. eCollection 2021.
Findings from previous studies regarding the association between the Glasgow Prognostic Score (GPS) and overall survival (OS) of patients with advanced non-small cell lung cancer (NSCLC) were limited. This study aimed to investigate the prognostic value of GPS in patients with advanced NSCLC after adjusting for potential confounding factors. A retrospective cohort study was conducted in 494 patients with advanced NSCLC between 2009 and 2019. Clinicopathological characteristics (including GPS) were analyzed to determine predictors of OS using univariate and multivariate Cox proportional hazards models. Survival curves were estimated using the Kaplan-Meier method. Of the enrolled patients with advanced NSCLC, 66.46% were men and 53.85% were aged <60 years. The percentages of GPS scores of 0, 1, and 2 were 36.44%, 36.03%, and 27.53%, respectively. The median OS of the GPS 0, 1, and 2 groups were 23.27, 14.37, and 10.27 months, respectively (log-rank P <0.0001). A higher GPS was independently associated with an increased risk of death (P for trend = 0.0004) after full adjustment for potential confounders. The risk of death increased by 77% in the GPS 1 group (hazard ratio [HR]=1.77, 95% confidence interval [CI]=1.22-2.57, P=0.0027) and 109% in the GPS 2 group (HR=2.09, 95%CI=1.36-3.22, P=0.0008) compared with the GPS 0 group after adjustment. We did not find significant heterogeneity among the analyzed subgroups apart from sex (P interaction=0.017). High pretreatment GPS is independently associated with worse OS in patients with advanced NSCLC. GPS should be considered in patient counseling and decision-making and needs to be further validated by large-cohort and prospective studies.
先前关于格拉斯哥预后评分（GPS）与晚期非小细胞肺癌（NSCLC）患者总生存期（OS）之间关联的研究结果有限。本研究旨在探讨在调整潜在混杂因素后GPS对晚期NSCLC患者的预后价值。对2009年至2019年间的494例晚期NSCLC患者进行了一项回顾性队列研究。分析临床病理特征（包括GPS），使用单因素和多因素Cox比例风险模型确定OS的预测因素。采用Kaplan-Meier方法估计生存曲线。在纳入的晚期NSCLC患者中，66.46%为男性，53.85%年龄<60岁。GPS评分为0、1和2的百分比分别为36.44%、36.03%和27.53%。GPS 0、1和2组的中位OS分别为23.27、14.37和10.27个月（对数秩检验P<0.0001）。在对潜在混杂因素进行充分调整后，较高的GPS与死亡风险增加独立相关（趋势P=0.0004）。与GPS 0组相比，调整后GPS 1组的死亡风险增加了77%（风险比[HR]=1.77，95%置信区间[CI]=1.22-2.57，P=0.0027），GPS 2组增加了109%（HR=2.09，95%CI=1.36-3.22，P=0.0008）。除性别外，我们在分析的亚组中未发现显著异质性（交互作用P=0.017）。治疗前高GPS与晚期NSCLC患者较差的OS独立相关。在患者咨询和决策中应考虑GPS，并且需要通过大型队列和前瞻性研究进一步验证。
