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Glasgow prognostic score as a prognostic factor in metastatic castration-resistant prostate cancer treated with docetaxel-based chemotherapy. | LitMetric

Glasgow prognostic score as a prognostic factor in metastatic castration-resistant prostate cancer treated with docetaxel-based chemotherapy.

Clin Genitourin Cancer

Sydney Cancer Centre, Concord Repatriation General Hospital, Concord, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.

Published: December 2013

AI Article Synopsis

  • The modified Glasgow Prognostic Score (mGPS) is a valuable tool derived from albumin and C-reactive protein (CRP) levels, showing significant prognostic value for overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC).
  • In a study with 220 chemotherapy-naive patients treated with docetaxel and prednisone, mGPS was independently associated with survival, with lower scores indicating better outcomes.
  • The neutrophil-lymphocyte ratio (NLR) did not show prognostic value for OS in this context, making mGPS a potentially useful metric for routine clinical assessments, pending further validation.

Article Abstract

Background: The modified Glasgow Prognostic Score (mGPS), derived from C-reactive protein (CRP) and albumin levels, and the neutrophil-lymphocyte ratio (NLR) have demonstrated prognostic significance in a number of malignancies.

Patients And Methods: Baseline mGPS and NLR were calculated in a prospective cohort of chemotherapy-naive patients with metastatic castration-resistant prostate cancer (mCRPC) (AT-101-CS-205 trial) who received docetaxel and prednisone ± AT101. Cox proportional hazards regression models estimated their effects on overall survival (OS).

Results: Of 220 eligible patients, mGPS and neutrophil and lymphocyte counts were available for 184, 193, and 112 patients, respectively. Albumin (hazard ratio [HR], 0.28; 95% confidence interval [CI]: 0.14-0.56; P < .001) and CRP (HR, 1.22; 95% CI, 1.00-1.48; P = .048) were independently prognostic for OS. An association between mGPS and OS was found (HR, 1.87; 95% CI, 1.35-2.59; P < .001; median survival, 23.5 months at mGPS 0 vs. 9.8 months at mGPS 2). mGPS was significant after controlling for 3 previously published nomograms or NLR (P ≤ .001). NLR was not prognostic for OS (HR, 0.98; P = .91), and no association between mGPS and toxicity was noted.

Conclusion: Our results demonstrate the prognostic role of the mGPS in mCRPC over variables previously identified. mGPS is inexpensive, easily measured, and could be incorporated into routine clinical testing if our results are confirmed in a subsequent validation study. The utility of the NLR in mCRPC remains uncertain despite evidence in other malignancies.

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Source
http://dx.doi.org/10.1016/j.clgc.2013.04.020DOI Listing

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