Prognostic value of preoperative inflammatory markers in resectable biliary tract cancer Validation and comparison of the Glasgow Prognostic Score and Modified Glasgow Prognostic Score in a Western cohort
Prognostic value of preoperative inflammatory markers in resectable biliary tract cancer Validation and comparison of the Glasgow Prognostic Score and Modified Glasgow Prognostic Score in a Western cohort
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DOI：
10.1016/j.ejso.2019.12.008
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发表时间：
2020-05-01
期刊：
影响因子：
3.8
通讯作者：
Sparrelid, Ernesto
中科院分区：
文献类型：
--
作者：
Jansson, Hannes;Cornillet, Martin;Sparrelid, Ernesto
引言：目前缺乏用于胆道癌（BTC）患者风险分层的既定术前预后因素。基于炎症的格拉斯哥预后评分（GPS）和改良格拉斯哥预后评分（mGPS）在BTC中的预后价值已在几个东部队列中得到证实。我们试图验证和比较的预后价值的GPS和mGPS的总生存期（OS），在一个大型的西方队列的患者BTC.Material和方法：我们进行了一项回顾性单中心研究期间2009年至2017年。评估了216例诊断为肝门周胆管癌（PHCC）、肝内胆管癌（IHCC）或胆囊癌（GBC）的连续手术探查患者。计算GPS和mGPS，其中术前测量CRP和白蛋白（n = 168/216）。结果：GPS和mGPS与生存率呈负相关（p < 0.001/p < 0.001），且在所有三个亚组中均具有显著相关性。GPS（而非mGPS）确定了一个中等风险组：GPS = 1的OS优于GPS = 2（p = 0.003），但OS低于GPS = 0（p = 0.008）。在多因素分析中切除的患者，GPS（p = 0.001）和mGPS（p = 0.03）仍然是显着的预测生存，独立于术后可用的风险factors.Conclusions：术前GPS和mGPS是独立的预后因素在BTC。在所有接受探查的患者中，仅在切除的患者中，以及在胆管癌和胆囊癌中均显示与OS的相关性。此外，GPS对低白蛋白血症的权重较高，可以识别出中等风险组。(C)2019 Elsevier Ltd，BASO-癌症外科协会和欧洲外科肿瘤学会。All rights reserved.
Introduction: Established preoperative prognostic factors for risk stratification of patients with biliary tract cancer (BTC) are lacking. A prognostic value of the inflammation-based Glasgow Prognostic Score (GPS) and Modified Glasgow Prognostic Score (mGPS) in BTC has been indicated in several Eastern cohorts. We sought to validate and compare the prognostic value of the GPS and the mGPS for overall survival (OS), in a large Western cohort of patients with BTC.Material and methods: We performed a retrospective single-center study for the period 2009 until 2017. 216 consecutive patients that underwent surgical exploration with a diagnosis of perihilar cholangiocarcinoma (PHCC), intrahepatic cholangiocarcinoma (IHCC), or gallbladder cancer (GBC) were assessed. GPS and mGPS were calculated where both CRP and albumin were measured pre-operatively (n = 168/216). Survival was analyzed by Kaplan-Meier estimate and uni-/multivariate Cox regression.Results: GPS and mGPS were negatively associated with survival (p < 0.001/p < 0.001), and the association was significant in all three subgroups. GPS, but not the mGPS, identified an intermediate risk group: with GPS = 1 having better OS than GPS = 2 (p = 0.003), but worse OS than GPS = 0 (p = 0.008). In multivariate analyses of resected patients, GPS (p = 0.001) and mGPS (p = 0.03) remained significant predictors of survival, independent of postoperatively available risk factors.Conclusions: Preoperative GPS and mGPS are independent prognostic factors in BTC. The association to OS was shown in all patients undergoing exploration, in resected patients only, and in both cholangiocarcinoma and gallbladder cancer. Furthermore, GPS which weights hypoalbuminemia higher could identify an intermediate risk group. (C) 2019 Elsevier Ltd, BASO-The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.