Department of Orthopedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan.
Department of Orthopedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan.
J Orthop Sci. 2024 Jul;29(4):1125-1129. doi: 10.1016/j.jos.2023.07.016. Epub 2023 Aug 1.
The modified Glasgow prognostic score (mGPS) is a reliable system for identifying patients at high risk of death among patients with soft tissue sarcoma (STS). The scoring systems use a combination of C-reactive protein (CRP) and albumin levels. Although patients with high-grade STS are at risk of metastasis and death, even if their mGPS is 0, the prognostic indicators in these patients are unknown. Therefore, we investigated useful prognostic indicators for survival and the development of metastasis in patients with high-grade STS and an mGPS of 0.
One hundred and four patients with CRP and albumin levels of <1.0 mg/dl and >3.5 g/dl, respectively, indicating an mGPS of 0, were included. The mean follow-up period was 79 months.
The 5-year disease-specific survival (DSS) rate was 79.2%. Cox proportional analysis showed that tumor size and absolute neutrophil count (ANC) were prognostic variables in multivariate analyses. Patients with higher ANC (ANC>3370/μl) had a worse DSS than those with lower ANC. The 5-year DSS was 74.7% vs. 91.7%, respectively (p = 0.0207). The 5-year metastasis-free survival was 67.2%. Tumor size and ANC remained significant variables for predicting the development of metastasis in the multivariate analysis. Patients with higher ANC had a worse metastasis-free survival than those with lower ANC. The 5-year metastasis-free survival was 59.5% vs. 87.3%, respectively (p = 0.00269).
When patients with high-grade STS have an mGPS of 0, the ANC and tumor size should be carefully evaluated. A higher neutrophil count and larger tumor size may increase the risk of metastasis development.
改良格拉斯哥预后评分（mGPS）是一种可靠的系统，可用于识别软组织肉瘤（STS）患者中的高死亡风险患者。评分系统结合了 C 反应蛋白（CRP）和白蛋白水平。尽管高级别 STS 患者有转移和死亡的风险，即使他们的 mGPS 为 0，这些患者的预后指标也未知。因此，我们研究了用于生存和高级别 STS 患者 mGPS 为 0 时转移发展的有用预后指标。
纳入了 CRP 和白蛋白水平分别为<1.0 mg/dl 和>3.5 g/dl 的 104 名患者，mGPS 为 0。平均随访时间为 79 个月。
5 年疾病特异性生存率（DSS）为 79.2%。Cox 比例风险分析显示，肿瘤大小和绝对中性粒细胞计数（ANC）是多变量分析中的预后变量。ANC 较高（ANC>3370/μl）的患者 DSS 较差，而 ANC 较低的患者 DSS 较好。5 年 DSS 分别为 74.7%和 91.7%（p=0.0207）。5 年无转移生存率为 67.2%。肿瘤大小和 ANC 在多变量分析中仍然是预测转移发展的重要变量。ANC 较高的患者无转移生存率较差，而 ANC 较低的患者无转移生存率较好。5 年无转移生存率分别为 59.5%和 87.3%（p=0.00269）。
当高级别 STS 患者的 mGPS 为 0 时，应仔细评估 ANC 和肿瘤大小。较高的中性粒细胞计数和较大的肿瘤大小可能会增加转移发展的风险。
