Value of the Glasgow Prognostic Score as a Prognostic Factor in Resectable Non–Small Cell Lung Cancer

• Published in: Journal of thoracic oncology 2016-08, Vol.11 (8), p.1311-1318
• Main Authors: Yotsukura, Masaya, Ohtsuka, Takashi, Kaseda, Kaoru, Kamiyama, Ikuo, Hayashi, Yuichiro, Asamura, Hisao
• Format: Article
• Language: English
• Subjects: C-Reactive Protein - analysis; Carcinoma, Non-Small-Cell Lung - blood; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Female; Humans; Inflammation; Lung cancer; Lung Neoplasms - blood; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Neoplasm Staging; Prognosis; Prognostic factor; Retrospective Studies; Serum Albumin - analysis; Surgery
• ISSN: 1556-0864; 1556-1380
• DOI: 10.1016/j.jtho.2016.04.029

Over the past decade, the Glasgow prognostic score (GPS), which is based on serum C-reactive protein and albumin levels, has been reported to be associated with the prognosis of patients with several types of inoperable and operable cancers. However, its applicability to operable non–small cell lung cancer (NSCLC) has not yet been established. We retrospectively collected data from patients with pathological stage I or II NSCLC who underwent complete resection. A total of 1048 patients were categorized as either GPS-0 (n = 817 [78.0%]), GPS-1 (184 [17.6%]), or GPS-2 (47 [4.5%]). Survival curves were estimated using the Kaplan-Meier method, and the Cox proportional hazard model was used to analyze the relationship between prognosis and GPS status. The 5-year overall survival (OS) rates were 91.2%, 78.3%, and 75.8% for GPS-0, GPS-1, and GPS-2, respectively. There were significant differences in OS between GPS-0 and GPS-1 (p < 0.001) and between GPS-0 and GPS-2 (p < 0.001). Ten variables demonstrated to be associated with OS in a univariate analysis were subjected to a multivariate analysis. The results showed that male sex (p = 0.031), vascular invasion (p < 0.001), lymph node metastasis (p < 0.001), and GPS (p = 0.025) were significantly associated with OS. A high GPS is significantly associated with poor OS. Although the biological mechanism that underlies this association is not clear, this inflammation-based score may be a useful indicator of the prognosis in patients with resectable NSCLC.