Prognostic significance of the glasgow prognostic score in patients undergoing pulmonary metastasectomy

Abstract

Pulmonary metastasectomy is considered the standard treatment for various cancer types when the primary tumour is under control. The Glasgow Prognostic Score (GPS), which is determined by serum levels of C-reactive protein (CRP) and albumin, is found to be a potential prognostic tool for variable primary cancer types. The aim of this study is to evaluate the prognostic role of the GPS in patients undergoing pulmonary metastasectomy for different subgroups of cancer types. Data of 142 patients who underwent pulmonary metastasectomy at in a single institution were retrospectively analyzed from a prospectively collected database. Primary tumour histologic subtypes were classified into five categories: Gastrointestinal tumours (Colorectal, gastric and colangiocellular carcinomas, n= 43), sarcomas (osteosarcoma, chondrosarcoma and synovial sarcoma, n= 38), breast carcinoma (n= 16), genitourinary system carcinomas (Cervix and endometrium carcinomas, n= 10) and miscellaneous (n= 35). High GPS is found to be correlated with worse survival rates in the subgroups of pulmonary metastasectomy for gastrointestinal, genitourinary and miscellaneous cancers (p= 0.050, p= 0.046 and p= 0.003, respectively). Although there is an evident decline of mean survival in breast cancer and sarcoma patients, the effect of GPS score on overall survival was statistically insignificant (p= 0.081 and p= 0.056, respectively). In conclusion, GPS appears to be a useful predictor of overall survival in pulmonary metastases for the majority of cancer types.