Department of Trauma and Orthopaedics, Glasgow Royal Infirmary, Glasgow, UK.
North of England Bone and Soft Tissue Tumour Service, Newcastle upon Tyne, UK.
Bone Joint J. 2022 Jan;104-B(1):168-176. doi: 10.1302/0301-620X.104B1.BJJ-2021-0874.R1.
The modified Glasgow Prognostic Score (mGPS) uses preoperative CRP and albumin to calculate a score from 0 to 2 (2 being associated with poor outcomes). mGPS is validated in multiple carcinomas. To date, its use in soft-tissue sarcoma (STS) is limited, with only small cohorts reporting that increased mGPS scores correlates with decreased survival in STS patients.
This retrospective multicentre cohort study identified 493 STS patients using clinical databases from six collaborating hospitals in three countries. Centres performed a retrospective data collection for patient demographics, preoperative blood results (CRP and albumin levels and neutrophil, leucocyte, and platelets counts), and oncological outcomes (disease-free survival, local, or metastatic recurrence) with a minimum of two years' follow-up.
We found that increased mGPS, tumour size, grade, neutrophil/lymphocyte ratio, and disease recurrence were associated with reduced survival. Importantly, mGPS was the best at stratifying prognosis and could be used in conjunction with tumour grade to sub-stratify patient survival.
This study demonstrated that prognosis of localized STS strongly correlates with mGPS, as an increasing score is associated with a poorer outcome. We note that 203 patients (41%) with an STS have evidence of systemic inflammation. We recommend the mGPS and other biochemical blood indicators be introduced into the routine diagnostic assessment in STS patients to stratify patient prognosis. Its use will support clinical decision-making, especially when morbid treatment options such as amputation are being considered. Cite this article: 2022;104-B(1):168-176.
改良格拉斯哥预后评分（mGPS）使用术前 CRP 和白蛋白计算 0 至 2 分的评分（2 分与不良预后相关）。mGPS 在多种癌症中得到验证。迄今为止，其在软组织肉瘤（STS）中的应用有限，只有小队列报告 mGPS 评分升高与 STS 患者生存率降低相关。
本回顾性多中心队列研究使用来自三个国家的六家合作医院的临床数据库确定了 493 名 STS 患者。各中心对患者人口统计学数据、术前血液检查结果（CRP 和白蛋白水平以及中性粒细胞、白细胞和血小板计数）以及肿瘤学结果（无病生存率、局部或转移性复发）进行回顾性数据收集，随访时间至少为两年。
我们发现 mGPS 升高、肿瘤大小、分级、中性粒细胞/淋巴细胞比值和疾病复发与生存率降低相关。重要的是，mGPS 是分层预后的最佳指标，可与肿瘤分级结合用于亚组分层患者的生存。
本研究表明，局部 STS 的预后与 mGPS 密切相关，因为评分升高与预后较差相关。我们注意到，41%（203 名）STS 患者存在全身炎症的证据。我们建议将 mGPS 和其他生化血液指标引入 STS 患者的常规诊断评估中，以分层患者的预后。它的使用将支持临床决策，尤其是在考虑截肢等有创治疗方案时。
