Utility of post-operative modified Glasgow Prognostic Score in localized renal cell carcinoma Público

Salastekar, Ninad Vikas (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/gh93gz975?locale=es
Published

Abstract

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

1. Introduction

1

2. Methods

2

3. Results

5

4. Discussion

6

5. Conclusion

9

6. References

10

7. Table 1

16

8. Table 2

17

9. Table 3

18

10. Table 4

19

11. Figure legends

20

12. Figure 1

21

13. Figure 2

22

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