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. 2016 Jun 27:9:3883-91.
doi: 10.2147/OTT.S103996. eCollection 2016.

Association between pretreatment Glasgow prognostic score and gastric cancer survival and clinicopathological features: a meta-analysis

Chun-Xiao Zhang  1 , Shu-Yi Wang  1 , Shuang-Qian Chen  1 , Shuai-Long Yang  1 , Lu Wan  1 , Bin Xiong  1
Affiliations

Association between pretreatment Glasgow prognostic score and gastric cancer survival and clinicopathological features: a meta-analysis

Chun-Xiao Zhang et al. Onco Targets Ther. .

Abstract

Background: Glasgow prognostic score (GPS) is widely known as a systemic inflammatory-based marker. The relationship between pretreatment GPS and gastric cancer (GC) survival and clinicopathological features remains controversial. The aim of the study was to conduct a meta-analysis of published studies to evaluate the association between pretreatment GPS and survival and clinicopathological features in GC patients.

Methods: We searched PubMed, Embase, MEDLINE, and BioMed databases for relevant studies. Combined analyses were used to assess the association between pretreatment GPS and overall survival, disease-free survival, and clinicopathological parameters by Stata Version 12.0.

Results: A total of 14 studies were included in this meta-analysis, including 5,579 GC patients. The results indicated that pretreatment high GPS (HGPS) predicted poor overall survival (hazard ratio =1.51, 95% CI: 1.37-1.66, P<0.01) and disease-free survival (hazard ratio =1.45, 95% CI: 1.26-1.68, P<0.01) in GC patients. Pretreatment HGPS was also significantly associated with advanced tumor-node-metastasis stage (odds ratio [OR] =3.09, 95% CI: 2.11-4.53, P<0.01), lymph node metastasis (OR =4.60, 95% CI: 3.23-6.56, P<0.01), lymphatic invasion (OR =3.04, 95% CI: 2.00-4.62, P<0.01), and venous invasion (OR =3.56, 95% CI: 1.81-6.99, P<0.01).

Conclusion: Our meta-analysis indicated that pretreatment HGPS could be a predicative factor of poor survival outcome and clinicopathological features for GC patients.

Keywords: Glasgow prognostic score; clinicopathological feature; gastric cancer; survival.

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Figures

Figure 1
Figure 1
The flow chart of study selection. Abbreviations: DFS, disease-free survival; OS, overall survival.
Figure 2
Figure 2
The forest plot between pretreatment GPS and OS in GC patients. Abbreviations: GPS, Glasgow prognostic score; OS, overall survival; GC, gastric cancer; HR, hazard ratio; CI, confidence interval; HGPS, high Glasgow prognostic score; LGPS, low Glasgow prognostic score.
Figure 3
Figure 3
The forest plot between pretreatment GPS and DFS in GC patients. Abbreviations: GPS, Glasgow prognostic score; DFS, disease-free survival; GC, gastric cancer; HR, hazard ratio; CI, confidence interval; HGPS, high Glasgow prognostic score; LGPS, low Glasgow prognostic score.
Figure 4
Figure 4
The forest plot between pretreatment GPS and clinicopathological parameters in GC. Notes: (A) TNM stage (III vs I and II); (B) lymph node metastasis (positive vs negative); (C) lymphatic invasion (positive vs negative); and (D) venous invasion (positive vs negative). Weights are random-effects analysis. Abbreviations: GPS, Glasgow prognostic score; GC, gastric cancer; TNM, tumor–node–metastasis; OR, odds ratio; CI, confidence interval; HGPS, high Glasgow prognostic score; LGPS, low Glasgow prognostic score.
Figure 5
Figure 5
Funnel plot of included studies reporting OS in GC patients. Notes: (A) Begg’s funnel plot for the assessment of potential publication bias; (B) funnel plot adjusted with trim and fill method. Circles: included studies. Squares: presumed missing studies. Abbreviations: OS, overall survival; GC, gastric cancer; HR, hazard ratio; SE, standard error.
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