The aim of this study was to investigate the possible prognostic factors and predictive accuracy of the Glasgow Prognostic Score (GPS) for patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) treated with chemoradiotherapy.
One hundred forty-two patients were enrolled in JCOG0303 and assigned to the standard cisplatin and 5-fluorouracil (PF)-radiotherapy (RT) group or the low-dose PF-RT group. One hundred thirty-one patients with sufficient data were included in this analysis. A Cox regression model was used to analyze the prognostic factors of patients with unresectable LAESCC treated with PF-RT. The GPS was classified based on the baseline C-reactive protein (CRP) and serum albumin levels. Patients with CRP ≤1.0 mg/dL and albumin ≥3.5 g/dL were classified as GPS0. If only CRP was increased or only albumin was decreased, the patients were classified as GPS1, and the patients with CRP >1.0 mg/dL and albumin <3.5 g/dL were classified as GPS2.
The patients’ backgrounds were as follows: median age (range), 62 (37–75); male/female, 119/12; ECOG PS 0/1/2, 64/65/2; and clinical stage (UICC 5th) IIB/III/IVA/IVB, 3/75/22/31. Multivariable analyses indicated only esophageal stenosis as a common factor for poor prognosis. In addition, overall survival tended to decrease according to the GPS subgroups (median survival time (months): GPS0/GPS1/GPS2 16.1/14.9/8.7).
Esophageal stenosis was identified as a candidate stratification factor for randomized trials of unresectable LAESCC patients. Furthermore, GPS represents a prognostic factor for LAESCC patients treated with chemoradiotherapy.
Ishida K, Ando N, Yamamoto S et al (2004) Phase II study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group (JEOG)/Japan Clinical Oncology Group Trial (JCOG9516). Jpn J Clin Oncol 34:615–619. doi: 10.1093/jjco/hyh107 CrossRefPubMed
Fujita H, Sueyoshi S, Tanaka T et al (2005) Esophagectomy: is it necessary after chemoradiotherapy for a locally advanced T4 esophageal cancer? Prospective nonrandomized trial comparing chemoradiotherapy with surgery versus without surgery. World J Surg 29:25–30. doi: 10.1007/s00268-004-7590-2 CrossRefPubMed
Brown DJF, Milroy R, Preston T et al (2007) The relationship between an inflammation-based prognostic score (Glasgow Prognostic Score) and changes in serum biochemical variables in patients with advanced lung and gastrointestinal cancer. J Clin Pathol 60:705–708. doi: 10.1136/jcp.2005.033217 CrossRefPubMed
Roxburgh CS, Crozier JE, Maxwell F et al (2009) Comparison of tumour-based (Petersen index) and inflammation-based (Glasgow Prognostic Score) scoring systems in patients undergoing curative resection for colon cancer. Br J Cancer 100:701–706. doi: 10.1038/sj.bjc.6604926 CrossRefPubMedPubMedCentral
Sobin LH, Fleming ID (1997) International Union Against Cancer TNM classification of malignant tumours, 5th edn. Springer, Berlin
Zhao KL, Liu G, Jiang GL et al (2006) Association of haemoglobin level with morbidity and mortality of patients with locally advanced oesophageal carcinoma undergoing radiotherapy—a secondary analysis of three consecutive clinical phase III trials. Clin Oncol 18:621–627. doi: 10.1016/j.clon.2006.04.015 CrossRef
Forrest LM, McMillan DC, McArdle CS et al (2004) Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 90:1704–1706. doi: 10.1038/sj.bjc.6601789 PubMedPubMedCentral
Al Murri AM, Bartlett JM, Canney PA et al (2006) Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer 9:227–230 CrossRef
Ohira M, Kubo N, Masuda G et al (2015) Glasgow prognostic score as a prognostic clinical marker in T4 esophageal squamous cell carcinoma. Anticancer Res 35:4897–4901 PubMed
- Esophageal stenosis and the Glasgow Prognostic Score as independent factors of poor prognosis for patients with locally advanced unresectable esophageal cancer treated with chemoradiotherapy (exploratory analysis of JCOG0303)
Japan Esophageal Oncology Group/Japan Clinical Oncology Group
- Springer Japan
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