Objective: To assess post-operative modified Glasgow Prognostic Score (mGPS) as an independent predictor of relapse-free survival (RFS) and cancer-specific survival (CSS) after nephrectomy in patients with localized renal cell carcinoma.
Methods: Patients with clinically localized (T1-T3N0M0) clear cell RCC were followed prospectively following potentially curative nephrectomy. Patient age, sex, race, tumor stage, grade and size, presence of necrosis, and both pre- and post-operative mGPS scores were considered as potential predictors of RFS and CSS. Patients were assigned 0, 1 or 2 mGPS points based on plasma levels of C - reactive protein (CRP) and serum albumin. Unadjusted and multivariable Cox regression analyses examined the association of various patient, disease and mGPS-related characteristics with RFS and CSS.
Results: Of the 509 patients in this study, 16% experienced disease recurrence or metastatic spread and 8% patients died due to RCC. Post-operative mGPS scores of of 0, 1 and 2 were observed in 76%, 7% and 17% of patients with relapse, and in 74%, 5% and 21% of patients who died of RCC, respectively. In the multivariable analysis, male gender, tumor stage, grade, and post-operative (but not pre-operative) mGPS served as independent predictors of RFS. Similarly, tumor stage, grade, and post-operative (but not pre-operative) mGPS served as independent predictors of CSS.
Conclusion: Post-operative mGPS is a stronger predictor of relapse and cancer-specific mortality than the corresponding pre-operative score, in patients with surgically removed localized RCC. Clinicians may consider using post-operative mGPS to improve risk-stratification of RCC patients, especially with localized disease. This information may assist clinical decisions regarding patient counseling, post-operative surveillance, or adjuvant therapy.
Table of Contents
Table of Contents
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About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Utility of post-operative modified Glasgow Prognostic Score in localized renal cell carcinoma ()||2018-08-28||