Clinical utility of the Glasgow Prognostic Score in patients undergoing curative nephrectomy for renal clear cell cancer: basis of new prognostic scoring systems.
Clinical utility of the Glasgow Prognostic Score in patients undergoing curative nephrectomy for renal clear cell cancer: basis of new prognostic scoring systems.
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DOI：
10.1038/bjc.2011.556
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发表时间：
2012-01-17
影响因子：
8.8
通讯作者：
McMillan, D. C.
中科院分区：
文献类型：
--
作者：
Lamb, G. W. A.;Aitchison, M.;Ramsey, S.;Housley, S. L.;McMillan, D. C.
最近使用 C 反应蛋白和白蛋白的选择性组合（改良格拉斯哥预后评分，mGPS）对恶性肿瘤中全身炎症反应的测量进行了改进。这对于转移性肾癌患者具有预后价值。本研究探讨了 mGPS 对接受透明细胞癌根治性肾切除术的患者的预后价值。对 1997 年 3 月至 2007 年 7 月期间在同一机构接受潜在根治性切除术的局限性肾细胞癌患者进行了前瞻性研究。构建了 mGPS、加州大学洛杉矶分校综合分期系统 (UISS)、“分期大小分级坏死”(SSIGN)、Kattan 和 Leibovich 评分。总共对 169 名患者进行了研究。最短随访时间为 49 个月；幸存者的中位随访时间为 98 个月。在此期间，35名患者死于癌症；另有 24 名患者死于并发疾病。在评分系统的单变量生存分析中，Kattan (P<0.05)、UISS (P<0.001)、SSIGN (P<0.001) 和 Leibovich (P<0.001) 与癌症特异性生存显着相关。以 4 年癌症特异性死亡率为终点，Kattan 的受试者工作曲线下面积为 0.726（95% CI 0.629–0.822；P=0.001），UISS 为 0.776（95% CI 0.671–0.880；P<0.001），UIS 为 0.812（95% CI 0.733–0.892；P<0.001）。 SSIGN 为 P<0.001)，Leibovich 为 0.778 (95% CI 0.666–0.889；P<0.001)，mGPS 评分系统为 0.800 (95% CI 0.687–0.912；P<0.001)。在显着独立评分系统和 mGPS 的多变量分析中，UISS（HR 3.08，95% CI 1.54-6.19，P=0.002）和 mGPS（HR 5.13，95% CI 2.89-9.11，P<0.001）是癌症特异性生存的显着独立预测因子。目前的前瞻性研究表明，mGPS（一种基于炎症的预后评分）对于接受肾透明细胞癌根治性肾切除术的患者来说，至少相当于且独立于其他当前经过验证的预后评分系统。 mGPS 很简单，可以在术前进行测量，基于标准化良好、广泛使用的蛋白质检测，因此为可手术肾癌患者的未来分期系统治疗前提供了客观合理的基础。
Measurement of the systemic inflammatory response in malignancy has been recently refined using a selective combination of C-reactive protein and albumin (modified Glasgow Prognostic Score, mGPS). This has prognostic value in patients with metastatic kidney cancer. This study examines the prognostic value of the mGPS in patients undergoing curative nephrectomy for clear cell cancer. Patients with localised renal cell carcinoma undergoing potentially curative resection between March 1997 and July 2007 in a single institution were prospectively studied. The mGPS, University of California Los Angeles Integrated Staging System (UISS), ‘Stage Size Grade Necrosis’ (SSIGN), Kattan and Leibovich scores were constructed. A total of 169 patients were studied. The minimum follow-up was 49 months; the median follow-up of the survivors was 98 months. During this period, 35 patients died of their cancer; a further 24 patients died of intercurrent disease. On univariate survival analysis of the scoring systems, Kattan (P<0.05), UISS (P<0.001), SSIGN (P<0.001) and Leibovich (P<0.001) were significantly associated with cancer-specific survival. Using cancer-specific mortality at 4 years as an endpoint, the area under the receiver operator curve was 0.726 (95% CI 0.629–0.822; P=0.001) for Kattan, 0.776 (95% CI 0.671–0.880; P<0.001) for UISS, 0.812 (95% CI 0.733–0.892; P<0.001) for SSIGN, 0.778 (95% CI 0.666–0.889; P<0.001) for Leibovich and 0.800 (95% CI 0.687–0.912; P<0.001) for the mGPS scoring system. On multivariate analysis of significant independent scoring systems and mGPS, UISS (HR 3.08, 95% CI 1.54–6.19, P=0.002) and mGPS (HR 5.13, 95% CI 2.89–9.11, P<0.001) were significant independent predictors of cancer-specific survival. The present prospective study shows that the mGPS, an inflammation-based prognostic score, is at least equivalent to and independent of other current validated prognostic scoring systems for patients undergoing curative nephrectomy for renal clear cell cancer. The mGPS is simple, measured preoperatively, based on well-standardised, widely available protein assays, and therefore provides an objective and rational basis before treatment for future staging systems in patients with operable renal cancer.
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影响因子：
2.1
作者：
Johnson, T. V.;Abbasi, A.;Master, V. A.
通讯作者：
Master, V. A.
影响因子：
45.3
作者：
Zisman, A;Pantuck, AJ;Belldegrun, AS
通讯作者：
Belldegrun, AS
影响因子：
4.5
作者：
Lamb, Gavin W. A.;McArdle, Peter A.;McMillan, Donald C.
通讯作者：
McMillan, Donald C.
影响因子：
158.5
作者：
Motzer, Robert J.;Hutson, Thomas E.;Figlin, Robert A.
通讯作者：
Figlin, Robert A.
影响因子：
6.6
作者：
Sorbellini, M;Kattan, MW;Russo, P
通讯作者：
Russo, P