Evaluation of an inflammation-based prognostic score in patients with metastatic renal cancer
Article first published online: 5 DEC 2006
Copyright © 2006 American Cancer Society
Volume 109, Issue 2, pages 205–212, 15 January 2007
How to Cite
Ramsey, S., Lamb, G. W. A., Aitchison, M., Graham, J. and McMillan, D. C. (2007), Evaluation of an inflammation-based prognostic score in patients with metastatic renal cancer. Cancer, 109: 205–212. doi: 10.1002/cncr.22400
- Issue published online: 8 JAN 2007
- Article first published online: 5 DEC 2006
- Manuscript Accepted: 18 OCT 2006
- Manuscript Revised: 12 OCT 2006
- Manuscript Received: 7 SEP 2006
- metastatic renal cancer;
- prognostic score;
- performance status;
- C-reactive protein;
- cancer-specific survival
Recently, it was shown that an inflammation-based prognostic score, the Glasgow Prognostic Score (GPS), provides additional prognostic information in patients with advanced cancer. The objective of the current study was to examine the value of the GPS compared with established scoring systems in predicting cancer-specific survival in patients with metastatic renal cancer.
One hundred nineteen patients who underwent immunotherapy for metastatic renal cancer were recruited. The Memorial Sloan-Kettering Cancer Center (MSKCC) score and the Metastatic Renal Carcinoma Comprehensive Prognostic System (MRCCPS) score were calculated as described previously. Patients who had both an elevated C-reactive protein level (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a GPS of 2. Patients who had only 1 of those 2 biochemical abnormalities were allocated a GPS of 1. Patients who had neither abnormality were allocated a GPS of 0.
On multivariate analysis of significant individual factors, only calcium (hazard ratio [HR], 3.21; 95% confidence interval [95% CI], 1.51–6.83; P = .002), white cell count (HR, 1.66; 95% CI, 1.17–2.35; P = .004), albumin (HR, 2.63; 95% CI, 1.38–5.03; P = .003), and C-reactive protein (HR, 2.85; 95% CI; 1.49–5.45; P = .002) were associated independently with cancer-specific survival. On multivariate analysis of the different scoring systems, the MSKCC (HR, 1.88; 95% CI, 1.22–2.88; P = .004), the MRCCPS (HR, 1.42; 95% CI, 0.97–2.09; P = .071), and the GPS (HR, 2.35; 95% CI, 1.51–3.67; P < .001) were associated independently with cancer-specific survival.
An inflammation-based prognostic score (GPS) predicted survival independent of established scoring systems in patients with metastatic renal cancer. Cancer 2007. © 2006 American Cancer Society.