Prognostic significance of the modified Glasgow prognostic score in elderly patients with gastric cancer
Prognostic significance of the modified Glasgow prognostic score in elderly patients with gastric cancer
复制标题
DOI：
10.1007/s00535-013-0855-5
复制
发表时间：
2014-06-01
影响因子：
6.3
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Hirashima, Kotaro;Watanabe, Masayuki;Baba, Hideo
格拉斯哥预后评分 (GPS) 是术前确定的基于炎症的评分。报告表明 GPS 与多种癌症类型的预后之间存在显着相关性。我们的目的是阐明改良GPS（mGPS）对因胃癌接受胃切除术的患者的预后意义。 纳入2005年3月至2011年3月期间接受胃切除术的294例胃癌患者，其中195例年龄<75岁（NE组）和99例年龄>75岁（E组）。 C反应蛋白水平升高（> 0.5 mg/dL）和低白蛋白血症（< 3.8 g/dL）的患者的mGPS为2，有1种异常的患者的mGPS为1，无异常的患者的mGPS为0。使用Cox比例风险模型和Kaplan-Meier分析来评估mGPS作为预后指标的有用性。通过 mGPS 分层的 3 组没有显着差异。在多变量Cox回归分析中，胃切除术的类型、腹膜转移和分期与不良预后独立相关。然而，mGPS 为 2 的 E 组患者的预后明显比 mGPS 为 0 或 1 的患者差。在这个年龄组中，分期和 mGPS 与不良预后独立相关。在年龄 > 75 岁接受潜在治愈性胃切除术的患者中，术前 mGPS 是生存的独立预测因子。因此，mGPS可以作为老年胃癌患者的一个有用的预后指标。
The Glasgow prognostic score (GPS) is a preoperatively determined inflammation-based score. Reports suggest a significant correlation between the GPS and prognosis in several cancer types. We aimed to clarify the prognostic significance of the modified GPS (mGPS) in patients undergoing gastrectomy for gastric cancer.Two hundred and ninety-four patients with gastric cancer, 195 aged < 75 years (group NE) and 99 aged > 75 years (group E), who underwent gastrectomy from March 2005 to March 2011 were enrolled. Patients with an elevated C-reactive protein level (> 0.5 mg/dL) and hypoalbuminemia (< 3.8 g/dL) were assigned a mGPS of 2, those with either 1 abnormality were assigned a mGPS of 1, and those with neither abnormality were assigned a mGPS of 0. Cox proportional hazard models and Kaplan-Meier analysis were used to evaluate the usefulness of mGPS as a prognostic indicator.In the NE group, the prognosis of the 3 groups stratified by mGPS did not differ significantly. In multivariate Cox regression analysis, the type of gastrectomy, peritoneal metastasis, and stage were independently associated with poor prognosis. However, group E patients with a mGPS of 2 had significantly poorer prognosis than those with a mGPS of 0 or 1. In this age group, stage and mGPS were independently associated with poor prognosis.In patients aged > 75 years undergoing potentially curative gastrectomy, the preoperative mGPS was an independent predictor of survival. Therefore, mGPS can be a useful prognostic indicator in elderly patients with gastric cancer.