Prognostic importance of the inflammation-based Glasgow prognostic score in patients with gastric cancer

BACKGROUND: The inflammation-based Glasgow prognostic score (GPS) has been shown to be a prognostic factor for a variety of tumours. This study investigates the significance of the modified GPS (mGPS) for the prognosis of patients with gastric cancer. METHODS: The mGPS (0=C-reactive protein (CRP) ≤ 10 mg l(-1), 1=CRP>10 mg l(-1) and 2=CRP>10 mg l(-1) and albumin<35 g l(-1)) was calculated on the basis of preoperative data for 1710 patients with gastric cancer who underwent surgery between January 2000 and December 2007. Patients were given an mGPS of 0, 1 or 2. The prognostic significance was analysed by univariate and multivariate analyses. RESULTS: Increased mGPS was associated with male patient, old age, low body mass index, increased white cell count and neutrophils, elevated carcinoembryonic antigen and CA19-9 and advanced tumour stage. Kaplan-Meier analysis and log-rank test revealed that a higher mGPS predicted a higher risk of postoperative mortality in both relative early-stage (stage I; P<0.001) and advanced-stage cancer (stage II, III and IV; P<0.001). Multivariate analysis demonstrated the mGPS to be a risk factor for postoperative mortality (odds ratio 1.845; 95% confidence interval 1.184-2.875; P=0.007). CONCLUSION: The preoperative mGPS is a simple and useful prognostic factor for postoperative survival in patients with gastric cancer.