The systemic inflammation-based Glasgow Prognostic Score as a powerful prognostic factor in patients with upper tract urothelial carcinoma

Teruo Inamoto, Hideyasu Matsuyama, Shigeru Sakano, Naokazu Ibuki, Kiyoshi Takahara, Kazumasa Komura, Tomoaki Takai, Takuya Tsujino, Yuki Yoshikawa, Koichiro Minami, Kazuhiro Nagao, Ryo Inoue, Haruhito Azuma

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction and Objective: The combination of C-reactive protein and albumin, the Glasgow Prognostic Score (GPS), had independent prognostic value in patients with varying cancers, except for upper tract urothelial carcinoma (UTUC). The aim of this study was to describe the relationship between GPS and survival in patients with UTUC after adjustment for other prognostic factors. Materials and Methods: We queried 2 UTUC databases. Retrospective clinical series on patients with localized UTUC managed by nephroureterectomy with bladder cuff, for whom data from the Yamaguchi Uro-Oncology Group and Osaka Medical College registry, including age, presence of bladder cancer, pT stage, lymphovascular invasion, C-reactive protein (CRP) and albumin, were analyzed. The GPS was constructed by combining CRP and albumin. Cancer specific survival (CSS) and overall survival (OS) and relative excess risk of death were estimated by GPS categories after adjusting for gender, age, ECOG performance status (PS), grade, and lymphovascular invasion (LVI). Results: Seven hundred and twenty four UTUC patients were identified. Our final cohort included 574 patients; of these, 29.2% died during a maximum follow up of 16.7 years. The estimated mean 10-year CSS of patients with GPS of scre-0, -1, and -2 was 99.5, 95.1, and 75.9 months, respectively. Patients with GPS of score-2 had poorest 10-year estimated mean OS of 67.6 months (57.2-77.9). Raised GPS also had a significant association with excess risk of cancer death at 10 years (GPS 2: Relative Excess Risk = 1.74, 95% CI 1.20-2.54) after adjusting for gender, patients' age, ECOG PS, and tumor focality. C-index of GPS both for CSS and OS were superior to patients' age and tumor focality, and comparable to grade. Conclusions: The GPS is an independent prognostic factor for CSS and OS after surgery with curative intent for localized UTUC. It significantly increases the accuracy of established prognostic factors. The GPS may provide a meaningful adjunct for patient counseling and clinical trial design.

Original languageEnglish
Pages (from-to)113248-113257
Number of pages10
JournalOncotarget
Volume8
Issue number68
DOIs
Publication statusPublished - 01-01-2017

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Inflammation
Carcinoma
Survival
Neoplasms
C-Reactive Protein
Albumins
Urinary Bladder Neoplasms
Registries
Counseling
Urinary Bladder
Clinical Trials
Databases

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Inamoto, Teruo ; Matsuyama, Hideyasu ; Sakano, Shigeru ; Ibuki, Naokazu ; Takahara, Kiyoshi ; Komura, Kazumasa ; Takai, Tomoaki ; Tsujino, Takuya ; Yoshikawa, Yuki ; Minami, Koichiro ; Nagao, Kazuhiro ; Inoue, Ryo ; Azuma, Haruhito. / The systemic inflammation-based Glasgow Prognostic Score as a powerful prognostic factor in patients with upper tract urothelial carcinoma. In: Oncotarget. 2017 ; Vol. 8, No. 68. pp. 113248-113257.
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title = "The systemic inflammation-based Glasgow Prognostic Score as a powerful prognostic factor in patients with upper tract urothelial carcinoma",
abstract = "Introduction and Objective: The combination of C-reactive protein and albumin, the Glasgow Prognostic Score (GPS), had independent prognostic value in patients with varying cancers, except for upper tract urothelial carcinoma (UTUC). The aim of this study was to describe the relationship between GPS and survival in patients with UTUC after adjustment for other prognostic factors. Materials and Methods: We queried 2 UTUC databases. Retrospective clinical series on patients with localized UTUC managed by nephroureterectomy with bladder cuff, for whom data from the Yamaguchi Uro-Oncology Group and Osaka Medical College registry, including age, presence of bladder cancer, pT stage, lymphovascular invasion, C-reactive protein (CRP) and albumin, were analyzed. The GPS was constructed by combining CRP and albumin. Cancer specific survival (CSS) and overall survival (OS) and relative excess risk of death were estimated by GPS categories after adjusting for gender, age, ECOG performance status (PS), grade, and lymphovascular invasion (LVI). Results: Seven hundred and twenty four UTUC patients were identified. Our final cohort included 574 patients; of these, 29.2{\%} died during a maximum follow up of 16.7 years. The estimated mean 10-year CSS of patients with GPS of scre-0, -1, and -2 was 99.5, 95.1, and 75.9 months, respectively. Patients with GPS of score-2 had poorest 10-year estimated mean OS of 67.6 months (57.2-77.9). Raised GPS also had a significant association with excess risk of cancer death at 10 years (GPS 2: Relative Excess Risk = 1.74, 95{\%} CI 1.20-2.54) after adjusting for gender, patients' age, ECOG PS, and tumor focality. C-index of GPS both for CSS and OS were superior to patients' age and tumor focality, and comparable to grade. Conclusions: The GPS is an independent prognostic factor for CSS and OS after surgery with curative intent for localized UTUC. It significantly increases the accuracy of established prognostic factors. The GPS may provide a meaningful adjunct for patient counseling and clinical trial design.",
author = "Teruo Inamoto and Hideyasu Matsuyama and Shigeru Sakano and Naokazu Ibuki and Kiyoshi Takahara and Kazumasa Komura and Tomoaki Takai and Takuya Tsujino and Yuki Yoshikawa and Koichiro Minami and Kazuhiro Nagao and Ryo Inoue and Haruhito Azuma",
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Inamoto, T, Matsuyama, H, Sakano, S, Ibuki, N, Takahara, K, Komura, K, Takai, T, Tsujino, T, Yoshikawa, Y, Minami, K, Nagao, K, Inoue, R & Azuma, H 2017, 'The systemic inflammation-based Glasgow Prognostic Score as a powerful prognostic factor in patients with upper tract urothelial carcinoma', Oncotarget, vol. 8, no. 68, pp. 113248-113257. https://doi.org/10.18632/oncotarget.22641

The systemic inflammation-based Glasgow Prognostic Score as a powerful prognostic factor in patients with upper tract urothelial carcinoma. / Inamoto, Teruo; Matsuyama, Hideyasu; Sakano, Shigeru; Ibuki, Naokazu; Takahara, Kiyoshi; Komura, Kazumasa; Takai, Tomoaki; Tsujino, Takuya; Yoshikawa, Yuki; Minami, Koichiro; Nagao, Kazuhiro; Inoue, Ryo; Azuma, Haruhito.

In: Oncotarget, Vol. 8, No. 68, 01.01.2017, p. 113248-113257.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The systemic inflammation-based Glasgow Prognostic Score as a powerful prognostic factor in patients with upper tract urothelial carcinoma

AU - Inamoto, Teruo

AU - Matsuyama, Hideyasu

AU - Sakano, Shigeru

AU - Ibuki, Naokazu

AU - Takahara, Kiyoshi

AU - Komura, Kazumasa

AU - Takai, Tomoaki

AU - Tsujino, Takuya

AU - Yoshikawa, Yuki

AU - Minami, Koichiro

AU - Nagao, Kazuhiro

AU - Inoue, Ryo

AU - Azuma, Haruhito

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Introduction and Objective: The combination of C-reactive protein and albumin, the Glasgow Prognostic Score (GPS), had independent prognostic value in patients with varying cancers, except for upper tract urothelial carcinoma (UTUC). The aim of this study was to describe the relationship between GPS and survival in patients with UTUC after adjustment for other prognostic factors. Materials and Methods: We queried 2 UTUC databases. Retrospective clinical series on patients with localized UTUC managed by nephroureterectomy with bladder cuff, for whom data from the Yamaguchi Uro-Oncology Group and Osaka Medical College registry, including age, presence of bladder cancer, pT stage, lymphovascular invasion, C-reactive protein (CRP) and albumin, were analyzed. The GPS was constructed by combining CRP and albumin. Cancer specific survival (CSS) and overall survival (OS) and relative excess risk of death were estimated by GPS categories after adjusting for gender, age, ECOG performance status (PS), grade, and lymphovascular invasion (LVI). Results: Seven hundred and twenty four UTUC patients were identified. Our final cohort included 574 patients; of these, 29.2% died during a maximum follow up of 16.7 years. The estimated mean 10-year CSS of patients with GPS of scre-0, -1, and -2 was 99.5, 95.1, and 75.9 months, respectively. Patients with GPS of score-2 had poorest 10-year estimated mean OS of 67.6 months (57.2-77.9). Raised GPS also had a significant association with excess risk of cancer death at 10 years (GPS 2: Relative Excess Risk = 1.74, 95% CI 1.20-2.54) after adjusting for gender, patients' age, ECOG PS, and tumor focality. C-index of GPS both for CSS and OS were superior to patients' age and tumor focality, and comparable to grade. Conclusions: The GPS is an independent prognostic factor for CSS and OS after surgery with curative intent for localized UTUC. It significantly increases the accuracy of established prognostic factors. The GPS may provide a meaningful adjunct for patient counseling and clinical trial design.

AB - Introduction and Objective: The combination of C-reactive protein and albumin, the Glasgow Prognostic Score (GPS), had independent prognostic value in patients with varying cancers, except for upper tract urothelial carcinoma (UTUC). The aim of this study was to describe the relationship between GPS and survival in patients with UTUC after adjustment for other prognostic factors. Materials and Methods: We queried 2 UTUC databases. Retrospective clinical series on patients with localized UTUC managed by nephroureterectomy with bladder cuff, for whom data from the Yamaguchi Uro-Oncology Group and Osaka Medical College registry, including age, presence of bladder cancer, pT stage, lymphovascular invasion, C-reactive protein (CRP) and albumin, were analyzed. The GPS was constructed by combining CRP and albumin. Cancer specific survival (CSS) and overall survival (OS) and relative excess risk of death were estimated by GPS categories after adjusting for gender, age, ECOG performance status (PS), grade, and lymphovascular invasion (LVI). Results: Seven hundred and twenty four UTUC patients were identified. Our final cohort included 574 patients; of these, 29.2% died during a maximum follow up of 16.7 years. The estimated mean 10-year CSS of patients with GPS of scre-0, -1, and -2 was 99.5, 95.1, and 75.9 months, respectively. Patients with GPS of score-2 had poorest 10-year estimated mean OS of 67.6 months (57.2-77.9). Raised GPS also had a significant association with excess risk of cancer death at 10 years (GPS 2: Relative Excess Risk = 1.74, 95% CI 1.20-2.54) after adjusting for gender, patients' age, ECOG PS, and tumor focality. C-index of GPS both for CSS and OS were superior to patients' age and tumor focality, and comparable to grade. Conclusions: The GPS is an independent prognostic factor for CSS and OS after surgery with curative intent for localized UTUC. It significantly increases the accuracy of established prognostic factors. The GPS may provide a meaningful adjunct for patient counseling and clinical trial design.

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