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The Glasgow Prognostic Score predicts poor survival in cisplatin-based treated patients with metastatic nasopharyngeal carcinoma.

Chen C, Sun P, Dai QS, Weng HW, Li HP, Ye S - PLoS ONE (2014)

Bottom Line: Among the above three inflammation-based prognostic scoring systems, GPS (P<0.001) and NLR (P = 0.019) were independently associated with overall survival, which showed to be stable in a bootstrap resampling study.The GPS consistently showed a higher AUC value at 6-month (0.805), 12-month (0.705), and 24-month (0.705) in comparison with NLR and PLR.Further analysis of the association of GPS with progression-free survival showed GPS was also associated independently with progression-free survival (P<0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

ABSTRACT

Background: Several inflammation-based prognostic scoring systems, including Glasgow Prognostic Score (GPS), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been reported to predict survival in many malignancies, whereas their role in metastatic nasopharyngeal carcinoma (NPC) remains unclear. The aim of this study is to evaluate the clinical value of these prognostic scoring systems in a cohort of cisplatin-based treated patients with metastatic NPC.

Methods: Two hundred and eleven patients with histologically proven metastatic NPC treated with first-line cisplatin-based chemotherapy were retrospectively evaluated. Demographics, disease-related characteristics and relevant laboratory data before treatment were recorded. GPS, NLR and PLR were calculated as described previously. Response to first-line therapy and survival data were also collected. Survival was analyzed in Cox regressions and stability of the models was examined by bootstrap resampling. The area under the receiver operating characteristics curve (AUC) was calculated to compare the discriminatory ability of each scoring system.

Results: Among the above three inflammation-based prognostic scoring systems, GPS (P<0.001) and NLR (P = 0.019) were independently associated with overall survival, which showed to be stable in a bootstrap resampling study. The GPS consistently showed a higher AUC value at 6-month (0.805), 12-month (0.705), and 24-month (0.705) in comparison with NLR and PLR. Further analysis of the association of GPS with progression-free survival showed GPS was also associated independently with progression-free survival (P<0.001).

Conclusions: Our study demonstrated that the GPS may be of prognostic value in metastatic NPC patients treated with cisplatin-based palliative chemotherapy and facilitate individualized treatment. However a prospective study to validate this prognostic model is still needed.

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Comparison of overall survival according to scoring systems, GPS (A), NLR (B) and PLR (C).
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pone-0112581-g001: Comparison of overall survival according to scoring systems, GPS (A), NLR (B) and PLR (C).

Mentions: Various potential prognostic factors including age, gender, karnofsky performance score before treatment, metastasis sites (liver and lung), number of involved sites, synchronous metastasis, disease-free interval, chemotherapy regimen, serum LDH, pre-treatment EBV DNA, GPS status, NLR and PLR were analyzed. Univariate analysis revealed that a larger number of involved sites (P = 0.020), higher baseline serum LDH level (P = 0.014), higher pretreatment EBV DNA level (P = 0.024), higher score of GPS (P<0.001) and higher value of NLR (P = 0.025) were considered adverse factors for overall survival (Table 2, Fig. 1). Age, gender, PLR and the other variables in the analysis had no prognostic relevance. In multivariate analysis, pre-treatment EBV DNA (P = 0.037), GPS (P<0.001) and NLR (P = 0.019) were independent prognostic factors (Table 2). The stability of this model was confirmed in a bootstrap resampling procedure. Among 1000 new models, pre-treatment EBV DNA was present in 69%, GPS appeared in 89% and NLR in 71%.


The Glasgow Prognostic Score predicts poor survival in cisplatin-based treated patients with metastatic nasopharyngeal carcinoma.

Chen C, Sun P, Dai QS, Weng HW, Li HP, Ye S - PLoS ONE (2014)

Comparison of overall survival according to scoring systems, GPS (A), NLR (B) and PLR (C).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230992&req=5

pone-0112581-g001: Comparison of overall survival according to scoring systems, GPS (A), NLR (B) and PLR (C).
Mentions: Various potential prognostic factors including age, gender, karnofsky performance score before treatment, metastasis sites (liver and lung), number of involved sites, synchronous metastasis, disease-free interval, chemotherapy regimen, serum LDH, pre-treatment EBV DNA, GPS status, NLR and PLR were analyzed. Univariate analysis revealed that a larger number of involved sites (P = 0.020), higher baseline serum LDH level (P = 0.014), higher pretreatment EBV DNA level (P = 0.024), higher score of GPS (P<0.001) and higher value of NLR (P = 0.025) were considered adverse factors for overall survival (Table 2, Fig. 1). Age, gender, PLR and the other variables in the analysis had no prognostic relevance. In multivariate analysis, pre-treatment EBV DNA (P = 0.037), GPS (P<0.001) and NLR (P = 0.019) were independent prognostic factors (Table 2). The stability of this model was confirmed in a bootstrap resampling procedure. Among 1000 new models, pre-treatment EBV DNA was present in 69%, GPS appeared in 89% and NLR in 71%.

Bottom Line: Among the above three inflammation-based prognostic scoring systems, GPS (P<0.001) and NLR (P = 0.019) were independently associated with overall survival, which showed to be stable in a bootstrap resampling study.The GPS consistently showed a higher AUC value at 6-month (0.805), 12-month (0.705), and 24-month (0.705) in comparison with NLR and PLR.Further analysis of the association of GPS with progression-free survival showed GPS was also associated independently with progression-free survival (P<0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

ABSTRACT

Background: Several inflammation-based prognostic scoring systems, including Glasgow Prognostic Score (GPS), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been reported to predict survival in many malignancies, whereas their role in metastatic nasopharyngeal carcinoma (NPC) remains unclear. The aim of this study is to evaluate the clinical value of these prognostic scoring systems in a cohort of cisplatin-based treated patients with metastatic NPC.

Methods: Two hundred and eleven patients with histologically proven metastatic NPC treated with first-line cisplatin-based chemotherapy were retrospectively evaluated. Demographics, disease-related characteristics and relevant laboratory data before treatment were recorded. GPS, NLR and PLR were calculated as described previously. Response to first-line therapy and survival data were also collected. Survival was analyzed in Cox regressions and stability of the models was examined by bootstrap resampling. The area under the receiver operating characteristics curve (AUC) was calculated to compare the discriminatory ability of each scoring system.

Results: Among the above three inflammation-based prognostic scoring systems, GPS (P<0.001) and NLR (P = 0.019) were independently associated with overall survival, which showed to be stable in a bootstrap resampling study. The GPS consistently showed a higher AUC value at 6-month (0.805), 12-month (0.705), and 24-month (0.705) in comparison with NLR and PLR. Further analysis of the association of GPS with progression-free survival showed GPS was also associated independently with progression-free survival (P<0.001).

Conclusions: Our study demonstrated that the GPS may be of prognostic value in metastatic NPC patients treated with cisplatin-based palliative chemotherapy and facilitate individualized treatment. However a prospective study to validate this prognostic model is still needed.

Show MeSH
Related in: MedlinePlus